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COMPLETE MEDICAL RECORD 



'RESIDENT iARFIELD'S IaSE, 



CONTAINING ALL OF THE 



OFFICIAL BULLETINS, 



2^rom. tli-e ^a,te of tla.e Sla.ootiaa.g- to tl3.e JDa.-y of IXis ^eatli. 



TOGETHER WITH THE 



OFFICIA^L ^UTOI^SY 



MADE SEPTEMBER 20, 1881, 



AND A DIAGRAM SHOWING THE COUR.SE TAKEN BY THE BALL. 



Compiled from the Records of the Executive Mansion. 



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washington, d. c. 

Chas. a. Wimer, Publisher. 

1881. 



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Entered according to act of Congress, in the year 1881, by 

CidAS. A. WIMER, 
In the Office of the Librarian of Congress at Washington. 



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PREFACE. , 



This volume is the result of a careful corapiP<^>n of the 
official record kept in President Glarfield's case^^^<^^ is issued 
in the present form (without any additions^ ^^^e nature 
of historical or other incidental informatio''^ order that 
it may preserve in its entirety a complete co^^'^^^^^fii of the 
official utterances of the physicians in cIp® °^ *'ie case ; 
thus making it an authentic reference-br " ^'^^ medical 
profession and general reader. 

The grateful acknowledgments of thr '^P^^^^ are extended 
to Mr. J. Stanley Brown, Private Sec^'-^' *^ ^^^^ late Presi- 
dent Garfield, for the material aid ^^^^ ^^ courteously 
afforded, and through whose coope'° ^^^® ^^^'^3' publica- 
tion of this volume is rendered po,'"" 

THE COMPILEK. 



COMPLETE MEDICAL RECORD 



'RESIDENT 6aRFIELD'S IaSE, 



CONTAINING ALL OF THE 



OFFICIAL BULLETINS, 



^roraa. tla.e ^a.te of tla.e Sla.ootin.g- to tla.e ^a^r o£ His IDeatli, 



TOGETHER WITH THE 



OFFICIA.L A^UTOP»SY, 



MADE SEPTEMBER 20, 1881, 



AND A DIAGRAM SHOWING THE COURSE TAKEN BY THE BALL. 



Compiled from the Records of the Executive Mansion. 



washington, d. c. 

Chas. a, Wlmer, Publisher. 

1881. 



Entered according to act of Congress, in tlie year 1881, by 

CMAS. A. Vv^IMER, 
In the Office of the Librarian of Congress at Wasliingtoii. 



PREFACE 



This volume is the result of a careful compilation of the 
official record kept in President Garfield's case, and is issued 
in the present form (without any additions in the nature 
of historical or other incidental information) in order that 
it may preserve in its entirety a complete compendium of the 
official utterances of the physicians in charge of the case ; 
thus making it an authentic reference-book for the medical 
profession and general reader. 

The grateful acknowledgments of the compiler are extended 
to Mr. J. Stanley Brown, Private Secretary to the late Presi- 
dent Garfield, for the material aid he has so courteously 
afforded, and through whose cooperation the early publica- 
tion of this volume is rendered possible. 

THE COMPILER. 






o 



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I 










K 



OFFICIAL BULLETINS. 



Executive Mansion. 
12 m. '/%2,1881. 

The President is somewhat restless, but is suffering less 
pam. Pulse 112. Some nausea and vomiting have recently 
occurred. Considerable hemorrhage has taken place from 
the wound. 

D. W. BLISS. 

Executive Mansion. 

July 2, 1881. 
12.35 p.m. 

The reaction from the shock of the injury has been very 
gradual. He is suffering some pain, but it is thought best 
not to disturb him by making any exploration for the ball 
until after the consultation at 3 p. m. 

D. W. BLISS. 



Executive Mansion. 

July 2, 1881. 
4 p. m. 

President's condition is now somewhat less favorable. 
Evidences of internal hemorrhage being distinctly recog- 
nized. 

Pulse, 130; temiDcrature of body, 96.8°, which is a little 
below normal. 

President suffers rather more pain, but mind is perfectly 
clear. 

D. W. BLISS. 



Executive Mansion, 

Juhj 2, 1881. 
6 p. M, 

The President has slept a few moments, but is manifestly 
weaker. Pulse 140, and feeble. 

He is mentally clear, conversing intelligently when per- 
mitted to do so. 

D. W. BLISS. 



Executive Mansion, 

July 3, 1881. 

1 A. M. 

The improvement in the President's condition, which began 
early in the evening, has steadily continued up to this hour. 

His temperature and respiration are now normal, and his 
pulse has fallen to 120. The attending physicians regard 
all his symptoms as favorable, and a more hopeful feeling 
prevails. 

D. W. BLISS. 



Executive Mansion, 

July 3, 1881. 

10 A. M. 

The President has rested quietly, and awakened refreshed ; 
and his improving condition gives additional hope of his 
gradual recovery. Pulse, 114 ; respiration, 18 ; and tem- 
perature about normal. 

D. W. BLISS. 



Executive Mansion, 

July 3, 1881. 
11a. m. 

The President's condition is greatly improved. He se- 
cures sufficient refreshing sleep, and during his waking hours 
is cheerful, and is inclined to discuss pleasant topics. Pulse, 
106, with more full and soft expression ; temperature and 
respiration normal. 

D. W. BLISS. 



Executive Mansion, 

July 3, 1881. 
2 p. M. 

The President has slept a good deal since hist bulletin, 
though occasionally suftering from pain in both feet and 
ankles. 

Pulse, 104 ; respiration, 18 ; temperature nearly normal. 
Whilst the President is by no means out of danger, yet his 
symptoms continue favorable. 

D. W. BLISS, 



Executive Mansion, 

July 3, 1881. 
■6 p. M. 

There is no appreciable change since the last l)ulletin. 
The President sleeps well at intervals. Pulse, 108 ; tem- 
perature and respiration normal. 

D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD. 



Executive Mansion, 

July 3, 1881. 
10.30 o'clock p. M. 

The condition of the President is less favorable. Pulse, 
120; temperature, 100°; respiration, 20. He is more rest- 
less, and again complains of the pain in his feet. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBERT REYBURN. 



Executive Mansion, 

July 4, 1881. 

12.30 A. AL 

The President's condition has changed very little since the 
last bulletin. Pulse, 112; temperature, 99.8°; respiration, 
20. Some tympanites is recognized. Does not complain so 
much of pain in the feet. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 

In view of the fact that it is deemed best to keep the 
President perfectly quiet during the night, no further exam- 
inations will be made and no other bulletins issued until 
7.30 this morning. 



Executive Mansion, 

July 4:, 1881. 
8.15 A. M. 

The condition of the President is not materially diiferent 
from that reported in the last bulletin. He has dozed at 
intervals during the night, and at times has continued to 
complain of the pain in his feet. 

The tympanites reported has not sensibly increased. 

Pulse, 108; temperature, 99.4°; respiration, 19. 

D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBERT REYBURN, 

FRANK H. HAMILTON, 

D. HAYES AGNEW. 



9 

Executive Mansion, 

„ ._ July 4, 1881. 

7.45 p. M. ^ ' 

The President this evening is not so comfortable. He 
does not suffer so much from pain in the feet. The tympa- 
nites is again more noticeable. Pulse, 126 ; temperature, 
101.9° ; respiration, 24. 

Another bulletin will be issued at 10 p. m., after which, in 
order not to distrub the President unnecessarily, no further 
bulletin will be issued till to-morrow mornin'j-. 

D. W. BLISS, 
J. J. WOODWARD, 
J. K. BARNES, 
ROBT. REYBURN. 

^^ Executive Mansion, 

^2.30 P.M. July 5, ISSl. 

The favorable condition of the symptoms reported in the 

last bulletin continues. There has been no recurrence of the 

vomiting. Pulse, 110 ; temperature, 101° ; respiration, 24. 

The President lies at present in a natural sleep. 

No further bulletin will be issued till 8.30 p. m., unless in 

case of an unfavorable change. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 
^•30 P. M. ^ juhj 5, 1881. 

The condition of the President continues as favorable as at 
the last bulletin. Pulse, 106 ; temperature 100.9° ; respira- 
tion, 24. 

No further bulletin will be issued till to-morrow morning, 
unless in case of unfavorable change, 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBERT REYBURN. 



10 

Executive Mansion, 

July 6, 1881. 
8.30 A. M. 

The President has passed a most comfortable night, and 
has slept well. His condition has remained throughout as 
favorable as when the last bulletin was issued. The pulse 
is becoming less frequent, and is now 98 ; temperature, 

98.9° ; respiration, 23. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD. 
ROBT. REYBURN. 

The next bulletin will be issued at 12 o'clock m. 



Executive Mansion, 
12.30 p. M. July 6, 1881. 

The President remains quite as comfortable as at the date 
of the last bulletin. He takes his nourishment well. PulsC; 
100; temperature, 99.7°; respiration, 23. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 

L^nless unfavorable symptoms develop no further bulletins 
will be issued till 8.30 this evening. 



Executive Mansion, 
8.30 p. M. July 6, 1881. 

The President's condition continues as favorable as at last 
report. He has passed a very comfortable day, taking more 
nourishment than yesterday. Pulse, 104; temperature, 

100.6^; respiration, 23. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBERT REYBURN. 

No further bulletin will be issued to-night unless the con- 
ditions become unfavorable. 



11 

Executive Mansion, 

July 7, 1881. 

9 A. M. 

The President has passed a most comfortable night, and 
continues steadily to improve. He is cheeriiil, and asks for 
additional food. Pulse, 94 ; temperature, 99.1° ; respira- 
tion, 23. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 
The next bulletin will be issued at 1 o'clock p. m. 



Executive Mansion, 

July 7, 1881. 

1 p. M. 

The condition of the President continues quite as favorable 
as this morning. Pulse, 100; temperature, 100.8°; respira- 
tion, 23. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBERT REYBURN. 
The next bulletin will be issued at 8.30 p. m. 



Executive Mansion, 

July 7, 1881. 
8 p. M. 

The favorable condition of the President continues. Pulse, 
106 ; temperature, 100.2°; respiration, 23. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBERT REYBURN. 
Unless unfavorable symptoms appear no further bulletin 
will be issued until to-morrow mornino-. 



12 

Executive Mansion, 

July 8, 1881. 

8.15 A. M. 

The condition of the President continues favorable. He is 
more comfortable than on any previous morning. Pulse, 96 ; 
temperature 99.2°; respiration, 23. The wound is beginning 
to discharge laudable pus. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 

The next bulletin will be issued at 1 o'clock p. m. 



Executive Mansion, 

July^, 1881. 
12.30 p. M. 

The progress of the President's case continues to be favor- 
able. Pulse, 108; temperature 101.4°; respiration 24. 

D.W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 

The President's condition continues so favorable that no 
further bulletin will be issued until 8.30 p. m. 



Executive Mansion, 

July 8, 1881. 
8. p. M. 

The President's condition continues favorable. He has 
passed a very comfortable afternoon, an"d has taken more 
nutriment than on previous days. Pulse, 108; temperature 
101.3°; respiration 24. 

D. W. BLISS, 
J. K. BARNES, 
J.J. WOODWARD, 
ROBT. REYBURN. 

The conditions continue so favorable there will be no 
further bulletin until to-morrow mornius;. 



13 

Executive Mansion, 
8.30 a.m. July 9, ISSl. 

The President has passed a tranquil night, and this morn- 
ing expresses himself as feeling quite comfortable. We 
regard the general progress of his case as very satisfactory. 
Pulse this morning, 100; temperature 99.4°; respiration 24. 

D. W BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 
The next bulletin will be issued at 1 p. m. 



Executive Mansion, 

July 9, 1881. 
1 p. M. 

The condition of the President continues to be favorable. 
Pulse, 104; temperature, 101.2°; respiration, 22. 

D. W. BLISS, 
J. J. WOODWARD, 
J. K. BARNES, 
ROBT. REYBURN. 
The next bulletin will be issued at 8.30 p. m. 



Executive Mansion, 
7.30 p. M. 

The President's condition has continued favorable during 
the day. The febrile reaction this afternoon does not differ 
materially from that of yesterday. Pulse, 108 ; tempera- 
ture, 101.9° ; respiration, 24. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 
The conditions are so favorable no further bulletin will be 
issued until to-morrow morninar. 



14 

Executive Mansion, 

July 10, 1881. 

8 A. M. 

The President has passed the most comfortable nij^ht he 
has experienced since he was wounded, sleeping tranqiiillj^ 
and with few breaks. The general progress of his symptoms- 
continues to be favorable. Pulse 106; temperature, 100°; 
resiiiration, 23. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBERT REYBURN. 

The next bulletin will be issued at one. 



Executive Mansion, 

Juhj 10, 1881. 

1 p. M. 

The President's symptoms continue to be favorable. Pulse. 
102 ; temperature, 100.5°; respiration, 22. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 

The next bulletin will be issued at 8.30 p. m. 



Executive Mansion, 

July 10, 1881. 
7 p. M. 

The President's symptoms continue to make favorable 
progress. Pulse, 108 ; temperature, 101.9°; respiration, 24. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD,, 
ROBT. REYBURN.. 
No further bulletin will be issued until to-morrow morning-. 



15 

Executive Mansion, 

July n, 1881. 

8 A. M. 

The President has passed a comfortable night, and his 
condition shows an improvement over that of yesterday. 
Pulse, 98; temperature, 99.2°; respiration, 22. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 

Bulletins will be issued daily at 8 a. m., 1 p. m., and 8.30 
p. M,, until further notice. 



Executive Mansion, 

July 11, 1881. 

1 p. M. 

The favorable progress of the President's case continues. 
Pulse, 106; temperature, 99.8°; respiration, 24. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

July 11, 1881. 
7 p. M. 

The President has had rather more fever this afternoon ; 
in other respects his condition is unchanged. Pulse, 108 ; 
temperature, 102.8°; respiration, 24. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



16 

Executive Mansion, 

July 12, 1881. 

8 A. M. 

The President is comfortable this morning. The rise of 
temperature noted in last evening's bulletin began to diminish 
about an hour later. 

Pulse, 96 ; temperature, 99.6°; respiration, 22. 

D. W. BLISS, 
J. K. BAPvNES, 
J. J, WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

July 12, 1881. 

1 p. M. 

The President is passing a comfortable day. Pulse, 100 ; 
temperature, 100.8°; respiration, 24. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

July 12, 1881. 
7 p. M. 

The President has passed a more comfortable day than 
yesterday. 

Pulse, 104 ; temperature, 102.4°; respiration, 24. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

July 13, 1881. 
8.30 A M. 

The President is doing well this morning. Pulse, 90 ; 
temperature, 98.5° ; respiration, 20. His gradual progress 
towards recovery is manifest, and thus far without serious 
complications. 

D. W. BLLSS, 
J. K. BARNES, 
J. J. WOODWARD. 
ROBT. REYBURN. 



Executive Mansion, 

Jidy 13, 1881. 
1 p. M. 

The President's condition continues favorable. Pulse, 94 ; 
temperature, 100.6° ; respiration, 22. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

July 13, 1881. 
7 p. M. 

The President has had less fever this afternoon than either 
yesterday or the day before. He continues slowly to improve. 
Pulse, 100 : temiDerature, 101.6° ; respiration, 24. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



18 

Executive Mansion, 

July 14, 1881. 

8.30 A. M. 

The President has passed a comfortable night, and con- 
tinues to do well. Pulse, 90 ; temperature, 99.8° ; respira- 
tion, 22. 

D. W. BLISS, 

J. K. BAKNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



Executive Mansion, 

July 14, 1881. 

1 p. M. 

The progress of the President's case continues to be satis- 
factory this morning. Pulse, 94 : temperature, 98.5° ; res- 
piration, 22. 

D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



Executive Mansion, 

July 14, 1881. 

7 p. M. 

The febrile .rise this afternoon has been less pronounced, 
and has not caused the President so much discomfort. His 
general condition is good. Pulse, 98 ; temperature, 101° ; 

respiration, 23. 

D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



19 

Executive Mansion, 

JuUi 15, 1881. 
8.30 A. M. 

The President has rested well during the night, is doing 
admirably this morning, and takes his food with relish. 
Pulse, 90 ; temperature, 98.5° ; respiration, 18. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWAPtD, 
ROBT. REYBURN. 



Executive Mansion, 

July 15, 1881. 

1 p. M. 

The President continues to do very well this morning. 
Pulse, 94 ; temperature, 98.5° ; respiration, 18. 

D. W. BLISS, 
J. K. BARINES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

Jw??/ 15,1881. 

7 P. M. 

The President has continued to do well during the day. 
The afternoon fever has been slighter than on any day since 
the 3d. Pulse, 98 ; temperature, 100.4° ; respiration, 20. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



20 

Executive Mansion, 

July 16, 1881. 
8.30 A. M. 

The President has passed another good night, and is 
steadily progressing toward convalescence. Pulse, 90 ; temp- 
erature, 98.5° ; respiration, 18. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 

In view of the favorable progress of the President's case, 
the surgeons have decided to issue bulletins hereafter only 
in the morning and evening. 



Executive Mansion, 

July 16, 1881. 
7 p. M. 

The President has passed a better day than any since he 
was hurt. The afternoon fever is still less than yesterday. 
At 1 p. M. his pulse was 94 ; temperature, 98.4°; respira- 
tion, 18. His pulse is now 98; temperature, 100.2°; respi- 
ration, 19. 

D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



Executive Mansion, 

July 17, 1881. 
8.30 A. M. 

The President continues to improve. He passed an excel- 
lent .night, and has a good appetite this morning. Pulse^ 
90 ; temperature, 98.4°; respiration, 18. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBERT REYBURN. 



21 

Executive Mansion, 

July 17, 1881. 

Y P. M. 

Our expectations of favorable progress have been fully 
realized by the manner in which the President has passed 
the day. He has taken more solid food, and with greater 
relish than hitherto, and his afternoon fever, which is as 
slight as that of yesterday, came on later. At 1 p. m. his 
pulse was 94, temperature, 98.5°; respiration, 18. At 
present, pulse, 98; temperature, 100.2°; respiration, 20. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

July 18, 1881. 
8.30 A. M. 

The President has passed another comfortable night, and 
is doing well this morning. Pulse, 88 ; temperature, 98.4°; 
respiration, 18. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

July 18, 1881. 
7 P. M. 

The President has had a little more fever this afternoon, 
which is regarded as merely a temporary fluctuation. At 
1 P. M. his pulse was 98 ; temperature, 98.5°; respiration, 18. 
At present his pulse is 102 ; temperature, 100.7°; respi- 
ration, 21. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



22 

ExEOUTiVE Mansion, 

July 19, 1881. 
8.30 A. M. 

The President has passed a very good night, and this 
morning he is free from fever and expresses himself as feeling 
quite comfortable. 

Pulse, 90; temperature, 98.5°; respiration, 18. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

July 19, 1881. 

7 P. M. 

The President has passed an excellent da}', and the after- 
noon fever has been less than on any day since he was 
wounded. 

At 1 p. M. his pulse was 92 ; temperature, 98.5°; respira- 
tion, 19. At present his pulse is 96 ; temperature, 99.8°; 
respiration, 19. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

July 20, 1881. 
8.30 A. M. 

The progress of the President towards recovery continues 
uninterruptedly. He has passed a quiet night. 

Pulse this morning 86 ; temperature, 98.4°; respiration, 18. 

D. W. BLISS, 
J. K. BARNES, 
J. J WOODWARD, 
ROBT. REYBURN. 



23 

Executive Mansion, 

July 20, 1881. 

7 p. M. 

The President has passed an excellent day. At 1 p. m. his 
pulse was 88 ; temperature 98.4°; respiration, 18. At the 
present time his pulse is 98 ; temperature, 99.0°; respira- 
tion, 19. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

July 21, 1881. 
8.30 A. M. 

The President has had a good night, and is doing excel- 
lently this morning. Pulse, 88 ; temperature, 98.4°; res- 
piration, 18. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBERT REYBURN. 



Executive Mansion, 

July 21, 1881. 
7 p. M. 

The President has had another good day. At 1 p. m. his 
pulse was 92 ; temperature, 98.4° ; respiration, 19. 

At 7 p.m.: pulse, 96 ; temperature, 99.9°; respiration, 19. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



24 

Executive Mansion, 

July 22, 1881. 
8.30 A. M. 

The President rested well during the night, and is quite 
easy this morning. Pulse, 88 ; temperature, 98.4^ ; respira- 
tion, 17. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

July 22, 1881. 
7.30 p. M. 

The progress of the President's case continues without 
material change. At 1 p. m. his pulse was 98; temperature, 
98.4° ; respiration, 18. 

At 7 P. M., pulse, 98 ; temperature, 100.2° ; respiration, 

19. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

July 23, 1881. 
10 A. M. 

The President was more restless last night, but this morn- 
ing at 7 o'clock, while preparations were made to dress his 
wound, his temperature was found to be normal. Pulse, 92 ; 
temperature, 98.4° ; respiration, 19. 

At 7.30 he had a slight rigor, in consequence of which the 
dressing of his wound was postponed. Reaction followed 
promptly, and the dressing has now just been completed. 
At present his pulse is 110 ; temperature, 101° ; respiration, 

24. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



25 

Executive Mansion, 

fhdy 23, 1881. 
7 p. M. 

After the bulletin of 10 a. m. the President's fever con- 
tinued. At 11.30 A. M. he had again a slight rigor, and his 
temperature subsequently rose until, at 12.30 p. m., it was 
104° ; pulse, 125 ; respiration, 2B. Between this time and 
1 P. M. perspiration made its appearance, and the tempera- 
ture began to fall gradually. It is now 101.7° ; pulse, 118 ; 
respiration, 25. There has been a free discharge of pus 
from the wound during the day. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

July 24, 1881. 
8.30 a. m. 

The President was more restless than usual during the 
night, and had another rigor just before midnight. This 
morning, at 8.15, his pulse was 98 ; temperature, 98.4°; res- 
piration, 18. A consultation was then held with Dr. Hamil- 
ton, of New York, and Dr. Agnew, of Philadelphia, after 
which a counter-opening was made through the integument 
of the back, about three inches below the wound, which, it 
is hoped, will facilitate the drainage of pus and increase the 
chances of recovery. The President bore the operation well, 
and his pulse is now 112. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



26 

Executive Mansion, 

Jnlij 24, 1881. 
7 p. M. 

The President has been much relieved by the oi)eration 
of this morning, and the pus has been discliarging satis- 
factory tlirough the new opening. At noon to-day his 
pulse was 118; temperature, 99.8°; respiration, 24. At 
present his pulse is 104 ; temperature, 99.2° ; respiration, 23. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 

Executive Mansion, 

July 25, 1881. 
8.30 A. M. 

The President has passed a more comfortable night, and 
has had no rigor since that reported in the bulletin of yester- 
day morning. He is doing well this morning. Pulse, 96 ; 
temperature, 98.4°; respiration, 18. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 

Executive Mansion, 

July 25, 1881. 
T p. M. 

The President has done well during the day. His after- 
noon fever did not come on until after three o'clock. It is 
somewhat higher than yesterday, but there has been no chill. 
At noon his pulse was 104 ; temperature, 98.4° ; respira- 
tion 20. At 7 P. M. his pulse was 110 ; temperature 101.8°; 
respiration, 24. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



27 

Executive Mansion, 

July 2r., 1881. 
8.30 A. M. 

The President was somewhat restless (lurinj): the nisht, 
and the fever, which had subsided after our last bulletin, rose 
again about midniglit and continued until 3 a. m., after which 
it again subsided. He is now about as well as yesterday at 
the same hour. Pulse, 102 ; temperature, 98. -4° ; respira- 
tion, 18. 

D. W. BLLS8, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

July 26, 1881. 
7 p. M. 

The President has done well during the day. At the 
dressing of the wound, after the morning bulletin was issued, 
a displaced spiculum of the broken rib about half an inch 
long was removed; the track of the wound at this point was 
dilated and a larger drainage tube inserted, for the purpose 
of facilitating the discharge of pus. Since that time he has 
had several quiet naps, has taken more nourishment than 
on any of the last five days, without gastric irritation, and 
when the wound was dressed this evening the discharge of 
healthy pus was satisfactorily abundant. At noon his pulse 
was 106 ; temperature 98.4°; respiration 19. At 7 p. m., 
pulse, 104 ; temperature 100.7°; respiration 22. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN, 
D. HAYES AGNEW. 



28 



Executive Mansion, 

Jvhj 27, 1881, 



8 A. M. 



The President slept sweetly last night from about 8 p. m. 
to 5 A. M.jWith but a single break of short duration at 11 p. M, 
Since 5 o'clock this morning he has dozed quietly, awaken- 
ing at intervals. There have been no rigors. He takes his 
nourishment well, and his general condition is improving. 
He expresses himself as feeling better and more rested. Pulse, 
94 ; temperature 98.4°; respiration 18. 

D. W. BLLSS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN, 
D. HAYES AGNEW. 



Executive Mansion, 

Jiily 27, 1881. 

12.30 p. M. 

The President's wound was dressed just after the morning 
bulletin was issued. It looks well, and the pus, which is 
healthy in character, is discharging freely. Since then he 
has rested quietly, and takes his nourishment readily and 
without gastric disturbance. 

At present his pulse is 90 ; temperature 98.4°; respiration 
18. 

D. W. BLISS, 
J K. BARNES, 
J.J.WOODWARD, 
ROBT. REYBURN. 



29 

Executive Mansion, 
July 27, 1881. 

Y p. M. 

The President is still resting quietly. He has been able 
to take more nourishment to day than for several days past, 
and up to the present hour has had no febrile rise of tempera- 
ture. His wound has just been dressed. It looks well and 
has continued to discharge healthy pus in sufficient quantity 
during the day. 

His pulse, is now 96; temperature 98.5°; respiration 20. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

July 28, 1881. 



8 A. M. 



The President rested well during the night and no rigor 
or febrile disturbance has occured since the bulletin of yester- 
day evening. This morning the improvement of his general 
condition is distinctly perceptible. He appears refreshed by 
the night's rest, and expresses himself cheerfully as to his 
condition. Pulse, 92 ; temperature 98.4°; respiration 18. 

FRANK H. HAMILTON, 

D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



30 

Executive Mansion, 

July 28, 1881. 

12.30 p. M. 

The President bore the dressing of his wound this morn- 
ing with less fatigue than hitherto. It appears well, and is 
discharging sufficiently. Shortly afterwards his bed was 
rolled into an adjoining room while that occupied till now 
is being throughly cleansed and put in order. His pulse is 
now 94 ; temperature 98.5°; respiration 18. 

FRANK H. HAMILTON, 

D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



Executive Mansion, 

July 28, 1881 . 

7 p. M. 

The President has passed a pleasant day, and has taken his 
nourishment with apparent relish. His temperature con- 
tinued normal until about 5 o'clock, when a moderate after- 
noon rise occurred, which, however, gives the patient but 
slight discomfort, and causes no anxiety. At present his 
pulse is 104; temperature, 100.5°; respiration, 20. 

FRANK H. HAMILTON, 

D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



Executive Mansion, 

Jnhf '1\), 1881. 



8.30 A. M. 



Immediately after the evening dressing yesterday the 

President's afternoon fever began gradually to subside. He 

slept well during the night, and this morning is free from 

fever, looks well, and expresses himself cheerfully. No 

rigors have occurred during the past twenty-four hours, nor 

indeed at any time since the 25th instant. A moderate rise 

of temperature in the afternoon is to be anticipated for some 

days to come. At present his pulse is 92 ; temperature, 98.4°; 

respiration, 18. 

FRANK H. HAMILTON, 

D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



Executive Mansion, 

July 29, 1881. 

12.30 p. M. 

The President bore the dressing of his wound well this 
morning, and exhibited very little fatigue after its com- 
pletion. The appearance of the wound, the character and 
quantity of the discharge, and the general condition of the 
patient are satisfactory. He rests well and takes an adequate 
quantity of nourishment. At present his pulse is 98 ; tem- 
perature, 98.4°; respiration, 19. 

FRANK H. HAMILTON, 

D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



32 

Executive Mansion, 

July 29, 1881. 

1 p. M. 

The President has been comfortable and cheerful during 
the day, and has had quite a nap since the noon bulletin was 
issued. The afternoon febrile rise came on later, and was 
not so marked as yesterday. The wound has been dis- 
charging freely and looks well. At present his pulse is 98 ; 
temperature, 100°; respiration, 20. 

FRANK H. HAMILTON, 

D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



Executive Mansion, 

July 30, 1881. 



8.30 A. M. 



The President enjoyed a refreshing sleep during the greater 
part of the night. The slight febrile rise of yesterday after- 
noon had subsided by midnight, and this morning his tem- 
perature is again normal. A gradual improvement of his 
general condition, in all particulars, is observable, and is 
recognized by himself. His pulse is now 92 ; temperature, 
98.5°; respiration, 18. 

FRANK H. HAMILTON, 

D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



33 

Executive Mansion, 

July 30, 1881. 
12.30 p. M. 

The President showed no fatigue from the dressing of his 
wound this morning. It looks very well, and the discharge 
of pus is satisfactory in quantity and quality. His general 
condition continues gradually to improve. A moderate 
quantity of solid food has been added to his nourishment, and 
was eaten with relish. A frame has been introduced beneath 
the mattress of his bed by which his head and shoulders have 
been elevated somewhat, and he expresses himself as well 
pleased with the change of position. At present his pulse is 
98 ; temperature, 98.5°; respiration, 20. 

FRANK H. HAMILTON, 

D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



Executive Mansion, 

'My 30, 1881. 
7 p. M. 

The President has passed the day comfortably without 
drawback or unpleasant symptoms, and has taken an ample 
amount of nourishment. The afternoon rise of temperatui'e 
is moderate, and did not commence until about five o'clock. 
The discharge of pus has been abundant, and at the evening 
dressing was washed away freely from the deeper parts of the 
wound. At present his pulse is 104 ; temperature, 100.2°; 
respiration, 20. 

FRANK H. HAMILTON, D. W. BLISS, 

D. HAYES AGNEW. J. K. BARNES, 

J. J. WOODWARD, 
ROBT. REYBURN. 



34 



Executive Mansion, 

July 31, 1881. 



8.30 A. M. 



The President slept well during the night, and awoke re- 
freshed this morning. The afternoon fever subsided earlier 
than the night before, and had quite disappeared by 10 p. m. 
His appearance and expressions this morning indicate con- 
tinued improvement. At present his pulse is 94 ; tempera- 
ture, 98,4°; respiration, 18. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN, 
D. HAYES AGNEW. 



Executive Mansion. 

./w^y 31, 1881. 

12.30 p. M. 

The President bore the morning dressing of his wound 
without fatigue. It continues to look well and discharge 
adequately. After the wound was dressed he ate, with relish, 
a breakfast of solid food, and has since passed a comfortable 
morning, during which he had a pleasant nap. The quan- 
tity of nourishment now taken daily is regarded as quite 
sufficient to support his system and favor the gradual increase 
in strength, which is plainly observable. At present his 
pulse is 100; temperature, 98-5°; respiration, 19. 

D. HAYES AGNEW. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



35 

Executive Mansion, 

July 31, 1881. 

7 p. M. 

The President has passed an excellent day. From just after 
the morning dressing till about 6 p. m. he has had his head and 
shoulders elevated by a frame beneath the mattress ; he has 
taken and relished an ample supply of nourishment, and con- 
tinues to improve in general condition. The appearance of 
the wound at the evening dressing was in every way satis- 
factory. The afternoon rise of temperature has been quite 
insignificant. At present his pulse is 104 ; temperature. 99 
respiration, 20. 

D. HAYES AGNEW. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



o. 



Executive Mansion, 

August 1, 1881. 



8.30 A. M. 



The President slept well during the night, and this morn- 
ing is cheerful and expresses himself as feeling better than 
at any time since he was hurt. After the slight rise of yes- 
terday afternoon his temperature became again normal early 
in the evening, and so continued. He appears stronger and 
has evidently made good progress on the road towards recov- 
ery during the last few days. His pulse is now 94 ; tempera- 
ture, 98.4° ; respiration, 18. 

D. HAYES AGNEW, 
D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBERT REYBURN. 



36 

Executive Mansion, 

August 1, 1881. 

12.30 p. M. 

The President's wound continues to do well. At the 
mornino- dressing it was found to be in all respects in a satis- 
factory condition. After the dressing was concluded his 
head and shoulders were raised in the same manner as yes- 
terday, and he took solid food for breakfast with more relish 
than he has hitherto shown. At present his pulse is 100 ; 
temperature, 98.4° ; respiration, 19. 

D HAYES AGNEW. D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



Executive Mansion, 

August 1, 1881. 

7 p. M. 

The President remained with his head and shoulders 
elevated until time for dressing his wound this evening. It 
continues to progress in a satisfactory manner and discharges 
healthy pus freely from the deeper as well as the superficial 
portions. He has taken nourishment well and in sufficient 
quantity, and in all respects continues to do well. The rise 
of temperature this afternoon is slight. At present his pulse 
is 104 ; temperature, 99.5° ; respiration 20. 

D HAYES AGNEW. D. W. BLISS, 

J. K. BARNES, 
J. J. W^OODWARD, 
ROBT. REYBURN. 



37 

Executive Mansion, 

Aicgiisf 2, 1881. 
8.30 A. M. 

The President passed a very pleasant night and slei>t sweetly 
the greater part of the time. This morning he awoke 
refreshed and appears comfortable and cheerful. Pnlse, 94 ; 
temperature, 98.4°; respiration, 18. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN, 
D. HAYES AGNEW. 



Executive Mansion, 

August 2, 1881. 
12.30 p. M. 

The President is passing the day comfortably with his head 
and shoulders raised in the same manner as yesterday. At 
the morning dressing his wound was found to be doing 
admirably. His pulse is now 99 ; temperature, 98.4° ; res- 
piration, 19. 

D. HAYES AGNEW. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

August 2, 1881. 
7 p. M. 

The President has continued to progress favorably during 
the day, and appears perceptibly better in his general condi- 
tion than yesterday, a more natural tone of voice being 
especially perceptible. The appearance of the external 
wounds, at the evening dresssing, was exceedingly good ; 
that made by the ball is rapidly granulating, while the dis- 



38 

charge from the deeper portion of the wound, which is 
abundant and healthy, comes through the counter opening 
made by" operation. The rise of temperature this afternoon 
is moderate and attended by no inconvenience to the patient. 
At present his pulse is 104 ; temperature, 100° ; respiration ; 
20. 

D. HAYES AGNEW. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 

Executive Mansion, 

August 3, 1881. 
8.30 A. M. 

The President slept tranquilly the greater part of the 
night. This morning liis temperature is normal, and his 
general condition is satisfactory. Another day of favorable 
progress is anticipated. At present ]iis pulse is 96 ; temper- 
ature 98.4° ; respiration, 18. 

D. HAYES AGNEW. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 

Executive Mansion, 

August 3, 1881. 
12.30 p. M. 

The President continues to progress steadily towards con- 
valescence. He has taken to-day an increased proportion of 
solid food, his wound is doing well, and his general condi- 
tion is better than yesterday. At present his pulse is 100 ; 
temperature, 98.4° ; respiration, 19. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



39 

Executive ^Mansion, 

August 3, 1881. 

7 p. M, 

The President has passed a very satisfactory dav The 
wound continues to do well ; he takes an adequate quantitv of 
nourishment, and appears in all respects better than at any 
time since he was injured. The rise of temperature this 
afternoon is slight. At present his pulse is 102 ; temper- 
ature, 99.4° ; respiration, 19. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

August 4, 1881. 

8.30 A. M. 

The President continues to improve. He slept well during 
the night, and this morning looks and expresses himself 
cheerfully. Another satisfactory day is anticipated. At 
present his pulse is 90 ; temperature, 98.4° ; respiration, 18. 

The next bulletin will be issued this evening, and here- 
after the noon bulletin will be dispensed with. 

FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



40 

Executive Mansion, 

August 4, 1881. 
7 p. M. 

As the morning bulletin indicated would probably be the 
case, the President has passed another good day, without draw- 
back or unpleasant symptom of any kind. He has taken his 
nourishment well, and shown little fatigue after his dressings 
and changes of position. The wound is doing well both in 
appearance and in the character and amount of discharge. 
At 12.30 p. M. his pulse was 96 ; temi)erature, 98.4^; respi- 
ration, 18. The afternoon rise of temperature came on late 
and was moderate in degree. At 7 p. m. his pulse is 102 ; 
temperature, 100.2°; respiration, 19. 

FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



Executive Mansion, 

Augusts, 1881. 
8.30 A. M. 

The President slept naturally the greater part of the night, 
although he has taken no morphia during the last twenty-four 
hours. His improved condition warranted, several days ago, 
a diminution in the quantity of morphia administered hypo- 
dermically at bed time, and it was reduced at first to ^^ and 
afterwards to j'g of ^ grain in the twenty-four hours, without 
any consequent unpleasant result, and finally has been alto- 
gether dispensed with. His condition this morning exhibits 
continued improvement, and another good day is anticipated. 
At i)resent his pulse is 88 ; temperature, 98.4°; respi- 
ration, 18. 

FBANK H. HAMILTON. D. W^ BLISS, 

J. K. BARNES, 

J. J. WOODAVARD, 

ROBT. REYBURN. 



41 

Executive Mansion, 

August 5, 1881. 

7 P. M. 

The President has passed another good day. The appear- 
ance of the wound and the character and amount of the dis- 
charge of pus continues satisfactory. He has taken an 
adequate quantity of nourishment, and has had several 
pleasant naps during the day. At 12.30 p. m. his pulse was 
98 ; temperature, 98.4°; respiration, 18. After 4 p. m. his 
temperature began to rise as usual, but to a moderate degree, 
and without perceptible dryness of skin. At present his 
pulse is 102 ; temperature, 100.4°; respiration, 19. 

FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



Executive Mansion, 

August 6, 1881. 



8.30 A. M. 



The President has passed an excellent night, sleeping 
sweetly the greater part of the time without the aid of mor- 
phia or any other anodyne. This morning he is cheerful and 
all the indications promise another favorable day. Pulse, 
92 ; temperature, 98.4°; respiration, 18. 

D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN, 

FRANK H. HAMILTON. 



42 

Executive Mansion, 
1 p. M. August 6, 1881. 

The President i)assecl a comfortable moniiug, his symp- 
toms and general condition being quite satisfactory. At 
12.30 i>. M. his pulse was 100 ; temperature, 98.5°; 
respiration, 19. During the afternoon he complained some- 
what of the weather. The external heat being such that it 
was found impracticable to keep the temperature of his room 
much below 90°, without closing the windows and doors, which 
was not thought prudent. The afternoon rise of his tem- 
perature began as late as yesterday, but has been higher, 
though unaccompanied by dryness of skin. At 7 p. m. his 
pulse was 102 ; temperature, 101.8°; respiration, 19. The 
appearance of the wound at the evening dressing was, how- 
ever, good, and there has been no interruption to the flow 
of pus. 

FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



Executive Mansion, 
8.30 A. M. Jugust 7, 1881. 

Shortly after the bulletin of last evening was issued the 
President fell into a pleasant sleep, during which the febrile 
rise subsided, and was no longer perceptible when he awoke 
at 10 p. M. Subsequently he slept well, though with occa- 
sional breaks during the rest of the night. No morphia or 
other anodyne was administered. This morning he is in good 
condition, although the effects of the febrile disturbance of 
yesterday are still slightly perceptible in pulse and tempera- 
ture. At i)resent his pulse is 96 ; temperature, 98-7°; 
respii'ation, 18. 

FRANK H. HAMILTON, D. W. BLISS, 

D. HAYES AONEW. J. K. BARNES, 

J. J. WOODWARD, 
ROBT. REYBURN. 



*7 P. M. 



43 

Executive Mansion, 

August 7, 1881, 



The President has been comfortable durin<; tlie day, 
although his temperature began to rise earlier than yesterday, 
and rose almost as high. At 12.30 p. m. his pulse was 104'; 
temperature, 100°; respiration, 20 At 7 p. m. liis pulse is 
104; temperature, 101.2°; respiration, 20 ; nevertlieless, he 
has been able to take nourishment as usual ; has had several 
refreshing naps during the day. The discharge of pus has 
been liberal and is healthy in character. 

FRANK H. HAMILTON, D. W. BLISS, 

D. HAYES AGNEW. J. K. BARNES, 

J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

August 8, 1881, 



8.30 a. m. 



The President passed a comfortable night, and slept well 
without anodyne. The rise of temperature of yesterday after- 
noon subsided during the evening, and did not recur at any 
time through the night. At present he appears better than 
yesterday morning. Pulse, 94 ; temperature, 98.4°; respi- 
ration, 18. 

FRANK H. HAMILTON, D. W. BLISS, 

D. HAYES AGNEW. J. K. BARNES, 

J. J. WOODWARD, 
ROBT. REYBURN. 



44 

Executive Mansion, 

Jug us f 8, 1881. 

10.30 A. M. 

It having become necessary to make a further opening to 
facilitate the escape of pus, we took advantage of the im- 
proved condition of the President this morning. Shortly after 
the morning bulletin was issued he was etherized, the incision 
extending downward and forward, and a counter-opening 
made into the track of the ball below the margin of the 
twelfth rib, which, it is believed, will effect the desired object. 
He bore the operation well, and has now recovered from the 
effects of etherization, and is in excellent condition. 

FRANK H. HAMILTON, D. W. BLISS, 

D. HAYES AGNEW. J. K. BARNES, 

J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

Augusts, 1881. 

7 p. M. 

After the last bulletin was issued the President suffered 
somewhat for a time from nausea due to the ether, but this 
has now subsided. He has had several refreshing naps, and 
his general condition is even better than might have been 
expected after the etherization and operation. At noon his 
pulse was 104 ; temperature, 100.2°; respiration, 20. At 
present his pulse is 108; temperature, 101.9°; respiration, 
19. Under the circumstances the fever must be regarded as 
moderate. 

D. HAYES AGNEW. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



45 



Executive Mansion, 

Aicgust i), 1881. 

8.30 A. M. 

Notwithstanding the effects of yesterday's operation the 
President slept the greater part of the night without the 
use of any anodyne. The febrile rise of yesterday after- 
noon slowly subsided during the night. This morning at 
8.30 his pulse is 98; temperature, 99.8° ; respiration, 19. 
Since yesterday afternoon small quantities of liquid nourish- 
ment, given at short intervals, have been retained, and this 
morning larger quantities are being administered without 
gastric disturbance. 



D. HAYES AGNEW. 



D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

August 9, 1881. 

12.30 p. M. 

At the dressing of the President's wound this morning it 
was found that pus had been discharging spontaneously and 
freely through the counter-opening made yesterday. He 
has been quite comfortable this morning and taken a lib- 
eral supply of liquid nourishment. His pulse is now 104 ; 
temperature, 99.7° ; respiration, 19. 



D. HAYES AGNEW. 



D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



46 

Executive Mansion, 
7 p. M. August 9, 1881. 

The President has been easy during the day, and has con- 
tinued to take the nourishment allowed, without gastric dis- 
turbances. The discharge of pus from his wound is quite 
abundant^ and it is evident that thorough drainage has been 
secured by yesterday's operation. The degree of fever this 
afternoon differs little from that of yesterday. Pulse, 106 ; 
temperature, 101.9° ; respiration, 19. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 
8 a. m. August 10, 1881. 

The President slept soundly during the night, and this 
morning his temperature is again normal, although his pulse 
is still frequent. At present it is 104 ; temperature, 98.5° ; 
respiration, 19. D. W. BLISS, 

J. K. BARNES. 
J. J. WOODWARD, 
ROBT. REYBURN. 

Executive Mansion, 
12.30 p. M. August 10, 1881. 

The President is getting through the day in a very satis- 
factory manner. He has asked for and taken a small quantity 
of solid food in addition to the liquid nourishment allowed. 
At the morning dressing the discharge of pus through the 
new opening was more free than at any previous time ; its 
character was good, and the wound looks well. His tempera- 
ture and respiration continue within the normal range, 
though the debility following the operation is still shown by 
frequency of pulse. At present his pulse is 100 ; tempera- 
ture, 98.6°; respiration, 19. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



47 

Executive Mansion, 

August 10, 1881. 

7 p. M. 

The President has passed an excellent day. The drainage 
of the wound is now efficient, and the }»ns secreted by its 
deeper portions has been coming away spontaneously. The 
afternoon rise of temperature is almost a degree less than 
yesterday and the day before. Pulse at present, 108 ; tem- 
perature, 101° ; respiration, 19. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

August 11, 1881. 



8.30 A. M. 



The President has passed an exceedingly good night, 
sleeping sweetly, with but few short breaks, and awaking 
refreshed this morning, at a later hour than usual. At the 
morning dressing, just completed, it was found that the 
deeper parts of the wound had been emptied spontaneously. 
The quantity of pus secreted is beginning to diminish ; its 
character and the appearance of the wound are healthy. His 
temperature shows an entire absence of fever this morning, 
and his pulse, which is less frequent than yesterday, is im- 
proving in quality. At present it is 100 ; temperature 98.6° ; 
respiration, 19. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



48 

Executive Mansion, 

August 11, 1881. 
12.30 p. M. 

The Pre.sident is doing very well to-day. Besides a liberal 
supply of liquid nourishment at regular intervals, he has 
taken for breakfast, with evident relish, an increased quantity 
of solid food. He continues free from fever, his skin moist, 
but without undue perspiration. Pulse, 102 ; temperature, 
98.6° ; respiration, 19. 

D. W. BLISS, 
J. K. BARNES. 
J. J. WOODWARD, 
ROBT. REYBURN. 

Executive Mansion, 

August 11, 1881. 
7 p. M. 

After the noon bulletin was issued the President's condi- 
tion continued as then reported until about 4 p. m., when 
the commencement of the afternoon febrile rise was noted. 
In its degree it did not differ mateiially from that of yester- 
day. His pulse is now 108; temperature, 101.2°; respira- 
tion, 19. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 

Executive Mansion, 

August 12, 1881. 
8.30 A. M. 

The President slept well the greater part of the night. 
The fever of yesterday afternoon subsided during the evening, 
and has not been perceptible since 10 p. m. His general 
condition this morning is good. Pulse, 100 ; temperature, 
98.6° ; respiration, 19. 

D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBERT REYBURN, 

FRANK H. HAMILTON. 



49 

Executive Mansion. 

August 12, 1881. 
12.30 p. M. 

The President has pa.ssed a comfortable morning. He 
continues to take, without repugnance, the liquid nourish- 
ment allowed, and ate, with relish, for breakfast a laiger 
quantity of solid food than he took yesterday. At present 
his pulse is 100 ; temperature 99.3°; respiration 19. 
FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



Executive Mansion, 

August 12, 1881. 

7 P. M. 

The President has passed a comfortable day. At the 
evening dressing the wound was found to be doing well. 
The quantity of pus secreted is gradually diminishing; its 
character is healthy. The rise of temperature this afternoon 
reached the same point as yesterday. At present the pulse 
is 108 ; temperature 101.2°; respiration 19. 
FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 
8.30 a. m. August 13, 1881. 

The President did not sleep as well as usual during the early 
part of last night. After midnight, however, his sleep 
was refreshing, and only broken at long intervals. This 
morning he has a little fever, nevertheless he expresses him- 
self as feeling better than for several days past. Pulse 104 ; 
temperature 100.8°; respiration 19. 

FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



50 

Executive Mansion, 

Augu-st 13, 1881. 
12.30 p. M. 

The President has been cheerful and easy during the morn- 
ing, and his temperature has fallen a little more than a 
degree and a half since the morning bulletin was issued. 
The wound is discharging healthy pus. His pulse is now 
102 ; temperature 99.2°; respiration 18. 

FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

Augtist 13, 1881. 
6.30 p. M. 

Since the last bulletin the President has continued to do 
well. The afternoon fever has been half a degree less than 
yesterday. At the evening dressing the appearance of the 
wound was improved. The discharge of pus has been 
adequate, and its character is healthy. At present his pulse 
is 104; temperature, 100.7°; respiration 19. 
FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 

Executive Mansion, 

August 14, 1881. 
8.30 a. m. 

The President slept well during the night, and this morning 
expresses himself as feeling comfortable. His temperature 
is one degree less than at the same hour yesterday. His 
general condition is good. Pulse, 100 ; temperature, 99.8° ; 

respiration 18. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



51 

Executive Mansion, 

Aiigust 14, 1881. 
12.30 p. M. 

The President has done well this morning ; his tempera- 
ture falling half a degree since the last bulletin was issued. 
At the morning dressing the condition of the wound was 
found to be excellent, and the discharge of pus adequate and 
healthy. Pulse, 96 ; temperature, 99.3° ; respiration, 18. 
D. HAYES AGNEW. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

August 14, 1881. 
6.30 p. M. 

The condition of the President has not materially changed 
since noon. The afternoon febrile rise is about the same as 
yesterday. Pulse, 108; temperature, 100.8°; respiration, 
19. 

D. HAYES AGNEW. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN, 



Executive Mansion, 

August 15, 1881. 
8.30 A. M. 

The President did not rest as well as usual last night. 
Until towards three o'clock his sleep was not sound, and he 
awoke at short intervals. His stomach was irritable and 
he vomited several times. About three o'clock he became 
composed and slept well until after seven this morning. His 
stomach is still irritable, and his temperature rather higher 
than yesterday morning. At present his pulse is 108 ; 
temperature, 100.2° ; respiration, 20. 

D. HAYES AGNEW. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



52 



Executive Mansion, 

August 15, 1881. 



12.30 p. M. 



Since the last bulletin the President has not again v^omited, 
and has been able to retain the nourishment administered. 
At the morning dressing the discharge of pus was free and 
of good character. Since then his pulse has been more fre- 
quent, but the temperature has fallen to a little below what 
it was at this time yesterday. At present his pulse is 118 , 
temperature, 99° ; respiration, 19. 

D. HAYES AGNEW, D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

August 15, 1881. 

6.30 p. M. 

The irritability of the President's stomach returned during 
the afternoon, and he has vomited three times since one 
o'clock. Although the afternoon rise of temperature is less 
than it has been for several days, the pulse and respiration 
are more frequent, so that his condition is, on the whole, 
less satisfactory. His pulse is now 130 ; temperature, 99.6° ; 
respiration, 22. 

D. HAYES AGNEW, D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



53 

Executive Mansion, 
8.30 A. M. Aicgust 16, 1881. 

The President was somewhat restless and vomited several 
times during the early part of the night. Since three o'clock 
this morning he has not vomited, and has slept tranquilly 
most of the time. Nutritious enemata are successfully 
employed to sustain him. Altogether the symptoms appear 
less urgent than yesterday afternoon. At present his pulse 
is 110 ; temperature, 98.6° ; respiration, 18. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN, 
D. HAYES AGNEW. 

Executive Mansion, 
12.30 p. M. August 16, 1881. 

The President has heen tranquil, and has not vomitted 
since the morning hulletin, hut has not yet rallied from the 
prostration of yesterday afternoon as much as was hoped. 
The enemata administered are, however, still retained. At 
present his pulse is 114 ; temperature, 98.3° ; resperation, 
18. 
D. HAYES AGNEW. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 

Executive Mansion, 
7 p. M. Aiujust 16, 1881. 

The President's symptoms are still grave, yet he seems to 
have lost no ground during the day, and his condition on the 
whole is rather hotter than yesterday. He has vomited hut 
once during the afternoon; the enemata are retained. At 
present his pulse is 120; temperature, 98.9° ; respiration, 
19. 
D. HAYES AGNEW. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



54 

Executive Mansion, 
8.30 A. M. August 17, 1881. 

The President has passed a tranquil night, sleeping most 
of the time. He continues to retain the nutritive enemata, 
and has not vomited since the last bulletin. His general 
condition appears more hopeful than this time yesterday. 
Pulse, 110; temperature, 98.3°; respiration, 18. 
FRANK H. HAMILTON, D. W. BLISS, 
D. HAYES AGNEW. J. K. BAPvNES, 

J. J. WOODWARD, 
ROBT. REYBURN. 

Executive Mansion, 
12.30 p. M. August 17, 1881. 

The President's condition has not materially changed since 

the last bulletin. He has been tranquil and has slept some; 

has not vomited, and the nutritive enemata are still 

retained. Pulse, 113; temperature, 98.7°; respiration, 18. 

FRANK H. HAMILTON, D. W. BLISS, 

D. HAYES AGNEW. J. K. BARNES, 

J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 
6.30 p. M. August 17, 1881. 

The President's condition is even better than it was this 
morning. There has been no vomiting during the day, and 
th«5 enamata continue to be retained. Moreover, a teaspoon- 
ful of beef extract has twice been administered by the mouth 
and not rejected, and small quantities of water swallowed 
from time to time excite no nausea. The wound continues 
to do well. 

At preseuT. liis pulse is 112 ; temperature, 98.8°; respi- 
ration, 18. 

FRANK H. HAMILTON, D. W. BLISS, 

D. HAYES AGNEW. J. K. BARNES, 

J. J. WOODWARD, 
ROBT. REYBURN. 



55 



Executive Mansion, 

August 18, 1881. 



8.30 A. M. 



The President has passed a very comfortable night, sleep- 
ing well the greater part of the time. There has been no 
further vomiting, and the nutritive enemata are still retained. 
This morning his pulse is slower and his general condition 
better than yesterday at the same hour. 

Pulse, 104; temperature, 98.8°; respiration, 17. 



FRANK H. HAMILTON, 
D. HAYES AGNEW. 



D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



12.30 p. M. 



Executive Mansion, 

August 18, 188T- 



Tiie President is suffering some discomfort this morning 
from commencing inflammation of the right parotid gland. 
In other respects, his condition is somewhat improved, and 
especially his stomach is becoming less intolerant. He has 
asked for and retained several portions of liquid nourishment,, 
much more than he could swallow yesterday. The nutritive 
enemata continue to be used with success. 

At present his pulse is 108 ; temperaturCj 98.4°; respi- 
ration, 18. 



FRANK H. HAMILTON. 



D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



56 

Executive Mansion, 
6.30 p. M. August 18, 1881. 

The President has done well during the day. He has taken 
additional nourishment by the moutli this afternoon, with 
evident relish, and without subsequent nausea. There is some 
rise of temperature, but his general condition is rather better 
than this time yesterday. Pulse. 108; temperature, 100; 
respiration, 18. 

FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion. 
8.30 a. m. August 19, 1881. 

The President slept much of the night, and this morning 
is more comfortable than yesterday. The swelling of the 
right })arotid gland has not increased since yesterday after- 
noon, and he is now^ free from pain. Nutritive enemata are 
still given with success, and liquid food has already this 
morning been swallowed and relished. Pulse, 100 ; tem- 
perature, 98.4°; respiration, 17. 

FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 
12.30 p. M. Aiujust 19, 1881. 

The President's condition has perceptibly impi-oved during 
the last twenty-four hours. The parotid swelling is evidently 
diminishing, and it has not pained him since last night. 
He is taking to-day an increased quantity of liquid food by 
the mouth, which is relished, and produces no gastric irrita- 
tion. Hispulseisnowl06; temperature, 98.8°; respiration, 17. 
FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



57 

Executive Mansion, 

August 19, 1881. 
6.30 p. M. 

The President has been easy during the afternoon, and the 
favorable conditions reported in the last bulletin continue. 
The swollen parotid gland has not been painful. The tem- 
perature is the same ; the pulse rather less frequent tlian at 
this hour 3'esterday. Pulse, 106 ; temperature, 100°; respi- 
ration, 18. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

August 20, 1881. 
8.30 A. M. 

The President has passed a quiet night, and this morning 
his condition does not differ materially from what it was 
yesterday at the same hour. The swelling of the parotid 
gland is unchanged and is free from pain. This morning 
his pulse is 98 ; temperature, 98.4°; respiration^ 18. 
D. HAYES AGNEW, D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

August 20, 1881. 
12.30 p. M. 

The President continues to do well. He is taking liquid 
food by the mouth in increased quantity and with relish. 
The nutritive enemata are still successfully given, but at 
longer intervals. His pulse is now 107 ; temperature, 98.4°; 
respiration, 18. At the morning dressing the wound was 



looking well and thepiis discharged was of healthy character. 
After the operation of August 8, the flexible tube used to 
wash out the wound at each dressing readily followed the track 
of the ball to the depth of three and a half or four inches. 
At the dressing, however, a small quantity of healthy pus 
came, as was believed, from the part of the track beyond this 
point, either spontaneously or after gentle pressure over the 
anterior surface of the right iliac region ; but this deeper 
part of the track was not reached by the tube until yesterday 
morning, when the separation of a small slough permitted 
it to pass, unresisted, downward and forward for the distance 
of twelve and a half inches from the external surface of the 
last incision. This facilitates the drainage and cleansing of 
the deeper parts of the wound, but has not been followed by 
any increase in the quantity of pus discharged. The large 
pus cavity which had formed in the immediate vicinty of the 
broken rib is filling up with healthy granulations, and the 
original wound of entrance, as far as that cavity, has healed. 

D. HAYES AGNEW. D. W. BUSS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

August 20, 1881. 
6.30 p. M. 

The President has passed the day quietly. He has been 
able to take more liquid food by the mouth than yesterday, 
and the quantity given by enema has been proportionally 
diminished. The parotid swelling remains about the same. 
Pulse, 110 ; temperature, 100° ; respiration, 19. 

D. HAYES AGNEW. D. W. BLISS, 



J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



59 

Executive Mansion'. 
S.30 A. M August 21, 1881. 

The President awoke more frequently than usual, yet slept 
sufficiently during the night, and appears comfortahle this 
morning. The parotid swelling is about the same, but is not 
painful. He took liquid nourishment by the mouth several 
times during the night, as well as this morning. Pulse, 
106 ; temperature, 98.8° ; respiration, 18. 

D. HAYES AGNEW. D. W. BLIS8, 

J. K. BARNES. 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 
12.30 p. M. August 21, 1881. 

The President's condition continues about. as at the morn- 
ing bulletin, except that there is a slight rise of temperature. 
He continues to take liquid nourishment by the mouth as 
well as by enema. Pulse, 108 ; temperature, 99.4° ; respira- 
tion, 18. 

D. HAYES AGNEW. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 

Executive Mansion, 
6.30 p. M. August 21, 1881. 

The President has vomited twice during the afternoon. 
The administration of food by the mouth has therefore again 
been temporarily suspended, and the nutritive enemata will 
be given more frequently. His temperature is lower and his 
pulse rather less frequent than yesterday afternoon. Tiie 
parotid swelling is painless, but stationary. Pulse, 108 ; 
temperature, 99.2°; respiration, 18. 

D. HAYES AGNEW. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



60 

Executive Mansion, 

August 22, 1881, 

8.30 A. M. 

The President has not vomited since yesterday afternoon, 
and this morning has twice asked for and received a small 
quantity of fluid nourishment by the mouth. He slept more- 
quietly during the night, and this morning his general con- 
dition is more encouraging than when the last bulletin was- 
issued. 

Pulse, 104 ; temperature, 98.4°; respiration, 18. 

D. HAYES AGNEW. D. W. BLISS, 

J. K. BAPtNES. 
J. J. WOODWARD, 
PtOBT. PvEYBURN. 



Executive Mansion, 

August 22, 1881, 



12.30 p. M. 



The President has continued this morning to retain liquid 
nourishment taken by the mouth, as well as by enema. 
There has been no recurrence of the vomiting and no nausea. 
The parotid swelling is not materially smaller, but continues 
painless. It has caused, for a day or two, an annoying ac- 
cumulation of viscid mucus in the back of the mouth, but 
tliis symptom has now much abated. 

At present his pulse is 104 ; temperature, 98.4°; respira- 
tion, 18. 

D. HAYES AGNEW. D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



61 

Executive Mansion, 

August 22, 1881. 
6.30 p. M. 

The President has continued to take liquid nourishment in 
small quantities at stated intervals during the entire day, and 
has had no return of nausea or vomiting. The nutritive enemata 
are also retained. The wound is looking well, and the work 
of repair is going on in all portions exposed to view. The 
pus discharge is healthy. Pulse, 110 ; temperature, 100.1°; 
respiration, 19. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWAFvD, 
ROBT. REYBURX, 
D. HAYES AGNEW. 



Executive Mansion, 

August 23, 1881. 
8.30 A. M. 

The President slept the greater part of the night, but 
awoke at frequent intervals. He has taken, since last evening, 
a larger quantity of liquid food by the mouth than in the 
corresponding hours of any day during the past week. The 
use of nutrient enemata is continued at longer intervals. 
The parotid swelling is unchanged. Pulse, 100 ; tempera- 
ture, 98.4°; respiration, 18. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN, 
D. HAYES AGNEW. 



62 

Executive Mansion, 

August 23, 1881. 

12.30 p. M. 

The President continues to take by the mouth and retain 
an increased quantity of liquid food. At tlie morning dress- 
ing the wound looked well, and tlie pus was of healthy 
character. The mucus accumulations in the back of the 
mouth, on account of the parotid swelling, is less viscid, and 
now gives but little trouble. At present his pulse is 104 ; 
temperature, 98. 9^^; respiration, 18. 

D.W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

^Mj/Ms/ 23, 1881. 

6.30 p. M. 

The President has continued to take liquid food by the 
mouth at regular intervals during the day, and has had no 
recurrence of gastric disorder. The parotid swelling remains 
unchanged ; in other respects, the symptoms show some im- 
provement over his condition yesterday afternoon. Pulse, 
104; temperature, 99.2°; respiration, 19. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



63 

Executive Mansion, 

August 24, 1881. 

8.30 A. M. 

The President has passed a very good nignt, awakening af 
longer intervals than during several nights past. He con- 
tinues to take liquid food by the nioutli with more relisli and 
in such quantity that the enemata will be suspended for the 
present. No change has yet been observed in the parotid 
swelling ; the other symptoms are quite as favorable as 
yesterday. 

Pulse, 100 ; temperature, 98.5°; respiration. It. 

FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

August 24, 1881. 

12.30 p. M. 

The President continues to take liquid food by the mouth, 
as reported in the last bulletin. His temperature has risen 
slightly since that time ; in other respects, his condition is 
about the same. 

Pulse, 104; temperature, 99. 2°; respiration, 17. 

FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES, 

.7. J. WOODWARD, 

ROBT. REYBURN. 



64 

Executive Mansion, 

August 24, 1881. 
6. 30 p. M. 

Shortly after the noon bulletin was issued an incision was 
made into the swelling on the right side of the President's 
face, for the purpose of relieving the tension of the swollen 
parotid gland and of giving vent to pus, a small quantity 
of which was evacuated. He has taken a larger quantity of 
liquid food by the mouth to-day than yesterday, and has 
been entirely free from nausea. His temperature this after- 
noon is, however, higher than yesterday at the same hour, 
and his pulse somewhat more frequent. 

Pulse, 108; temperature, 100.7°; respiration, 19. 

FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



Executive Mansion, 

August 25, 1881. 
8.30 A. M. 

The President slept most of the night. He has taken 
liquid food by the mouth at stated intervals and in sufficient 
quantity, so that the enemata have not been renewed. No 
modification of the parotid swelling has yet been observed. 
His general condition is much the same as at this time 
yesterday. Pulse, 106; temperature, 98.5° ; respiration, 18. 

D. HAYES AGNEW, D. W. BLISS, 

FRANK H. HAMILTON. J. K. BARNES, 

J. J. WOODWARD, 
ROBT. REYBURN. 



65 

Executive Mansion, 

August 25, 1881. 
9.15 A. M. 

The subject of the removal of the President tioiu Wasli- 
ington at the present time was earnestly considered by us 
last night and again this murning. After mature delibeia- 
tion the conclusion was arrived at by the majority that it 
would not now be prudent, although all agree that it will be 
very desirable at the earliest time at which his condition may 
warrant it. We are moreover unanimously of the opinion 
that at no time since the injury has the President exhibited 
any symptoms of malaria. 



FRANK H. HAMILTON 
D. HAYES AGNEW. 



D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

August 25, 1881. 
12.30 p. M. 

Since the issue of this morning's bulletin a rise in the 
President's temperature, similar to that which occurred 
yesterday morning, has been observed. His pulse is some- 
what more frequent. From the incision in the parotid swell- 
ing a few drops of pus were discharged this morning; the 
size of the swelling has not diminished. In other respects 
his condition has not perceptibly changed. Pulse, 112; 
temperature, 99.2° •, respiration, 19. 



FRANK H. HAMILTON. 



D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



66 

Executive Mansion, 

August 25, 1881. 
6.80 p. M. 

There has been little change in the President's condition 
since the noon bulletin was issued. The frequency of his 
pulse is now the same as then. His temperature has risen 
somewhat, but is not so high as yesterday evening. There 
has been a slight discharge of pus during the day from the 
incision in the parotid swelling, but it is not diminishing in 
size. No unfavorable change has been observed in the con- 
dition of the wound. He has taken by the mouth a sufficient 
supply of liquid food. At present his pulse is 112 ; tem- 
perature, 99.8° ; respiration, 19. 

FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

August 26, 1881. 
8.30 A. M. 

The President slept most of the night, awakening at inter- 
vals of half an hour to an hour. On first awakening there 
was, as there has been for several nights past, some mental 
confusion, which disappeared when he was fully roused, and 
occasionally he muttered in his sleep. These symptoms have 
abated this morning as on previous days. At present his 
temperature is slightly above the normal and his pulse a little 
more frequent than yesterday morning. Pulse, 108; tem- 
perature, 99.1°; respiration, 17. 

FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



67 

Executive Mansion, 

August 26, 1881. 
12.30 p. M. 

At the morning dressing of the President it was observed 
that pus from the parotid swelling had found its way sponta- 
neously into his right external auditory meatus, through 
which it was discharging ; some pus was also discharging 
through the incision made into the swelling. His wound 
looks as well as it has done for some time past. His pulse 
and temperature are at present higher than at the corres- 
ponding hour for some days. He continues to take by the 
mouth the liquid food prescribed, nevertheless we regard his 
condition as critical. 

Pulse 118; temperature 100°; respiration 18. 

FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

August 26, 1881. 
6.30 p. M. 

The President's condition has not changed materially 
since the last bulletin Avas issued. He continues to take by 
the mouth the liquid food prescribed, and occasionally asks 
for it. Since yesterday forenoon, commencing at 11 .30 a. m. , 
the enemata have again been given at regular intervals, as 
a means of administering stimulants as well as nutrition. 
They are retained without trouble. At present his pulse is 
116; temperature 99.9°; respiration 18. 

FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



68 

Executive Mansion, 

Aucju-st 27, 1881. 
8.30 A. M. 

The President slept from half an hour to an hour, or more, 
at a time throughout the night. He continues to retain the 
liquid food administered by the mouth, and the stimulating 
enemata ; nevertheless his pulse has been more frequent 
since midnight, and he is evidently feebler this morning than 
yesterday. 

Pulse, 120; temperature 98.4°; respiration 22. 

FRANK H. HAMILTON. D. W. BLISS, 

J. K. BAPvNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



Executive Mansion, 

August 27, 1881. 
12.30 p. M. 

There has been no improvement in the President's condi- 
tion, since the last bulletin was issued. He continues to 
retain the liquid food administered by the mouth as well as 
the enemata. At the morning dressing the parotid swelling 
appeared about the same as yesterday. No material change 
was observed in the wound. Since morning the tempera- 
ture has risen about a degree^ and the pulse has fluctuated 
somewhat. At present the pulse is 120; temperature 99.6°; 
respiration 22. 

FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES, 
J. J. W^OODWARD, 
ROBT. REYBURN. 



69 

Executive Mansion, 

August 21, 1881. 
6.30 p. M. 

The President's symptoms show slight amelioration this 
atternoon ; his pulse is somewhat less frequent, and his 
temperature lower ; moreover the mental disturbance de- 
scribed in yesterday morning's bulletin has disappeared. The 
parotid swelling has discharged a little pus by the opening 
spontaneously formed into the ear, as well as by the incision 
made, but is not perceptibly smaller. The liquid food given 
by the mouth, and the enemata continue to be retained. 

Pulse, 114: temperature, 98.9°; respiraion, 22. 

FRANK H. HAMILTON, D. W. BLISS, 

D. HAYES AGNEW. J. K. BARNES, 

J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

August 28, 1881. 
8.30 A. M. 

The amelioration of the President's symptoms announced 
in last evening's bulletin continued during the night, and 
since midnight some further improvement has been observed, 
the pulse progressively diminishing in frequency. The 
stomach has continued to retain the liquid nourishment ad- 
ministered, and last evening he asked for, and ate, a small 
quantity of milk-toast. Stimulating and nutrient enemata 
continue to be retained. There has been no mental disturb- 
ance during the night or this morning. At present his 
pulse is 100 ; temperature, 98.4° ; respiration, 17. 

FRANK H. HAMILTON, D. W. BLISS, 

D. HAYES AGNEW. J. K. BARNES, 

J. J. WOODW^\RD, 
ROBT. REYBURN. 



TO 

Executive Mansion, 

August 28, 1881. 
12.30 p. M. 

At the morning dressing of tlie President several yellowish 
points were observed just helow the ear over the swollen 
parotid, and an incision being made, about a teaspoonful of 
healthy looking pus escaped. There was also some discharge 
of pus through the two openings (into the ear and the incis- 
ion) mentioned in previous bulletins. The wound looks 
rather less indolent than it has been doing for several days 
past. Since the morning bulletin there has been some rise 
of temperature, but little increase in the frequency of jnilse, 
and in other respects no material change has occurred. 
Pulse, 104 ; temperature, 99.5°; respiration, 18. 
FRANK H. HAMILTON, D. W. BLISS, 
D. HAYES AGNEW. J. K. BARNES, 

J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 
August 28, 1881. 
6.30 p. M. 

The improvement in the President's condition declared 
yesterday afternoon is still maintained. He continues to take 
willingly the liquid food given by the mouth, and is appar- 
ently digesting it. The stimulants and nutrients given by 
enema are also retained. At the evening dressing an 
increased quantity of healtliy looking pus was discharged 
from the suppurating parotid. The appearance of the wound 
has not perceptibly changed since the morning dressing. 
But little rise in temperature or pulse has taken place since 
noon, and the pulse is perceptibly strongei" than this time 
yesterday. Pulse, 110 ; temperature, 99.7°; respiration 20. 
FRANK H. HAMILTON, D. W. BLISS, 
D. HAYES AGNEW. J. K. BARNES, 

J. J. WOODWARD, 
ROBERT REYBURN. 



71 

Executive Mansion, 

August 29, 1881. 
8.30 A M. 

The President, s symptoms this morning are as favorable 
as yesterdav at the same hour. He slei)t, awakeniny; at in- 
tervals, the greater part of the night. At these intervals he 
took, and retained, the liquid nourishment administered. 
His mind continues perfectly clear. 
Pulse, 100 ; temperature, 98.5" ; respiration, 17. 

D. HAYES AGNEW. D. W. BLISS, 

J. K. BAPtNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

August 29, 1881. 
12.30 p. M. 

At the morning dressing of the President an additional 
point of suppuration was recognized in his swollen face, 
whicli, being incised, gave exit to some healthy looking pus. 
The other openings on the exterior of the swelling are like- 
wise discharging, but though less tense, the tumefaction has 
not yet materially diminished in size. Nothing new has been 
observed in the condition of the wound. The usual daily 
rise of temperature has not yet occurred, and the general con- 
dition has not materially changed since morning. Pulse, 
106 ; temperature, 98.6° ; respiration 18. 

D. HAYES AGNEW. D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



72 

Executive Mansion, 

August 29, 1881. 
6.30 p. M. 

The daily rise of the President, s temperature began later 
this afternoon than yesterday, but rose eight-tenths of a 
degree higher. The frequency of his pulse is now the same 
as at this hour yesterday. He has taken willingly the liquid 
food prescribed during the day, and had besides, during the 
morning, a small piece of milk toast. At the evening dress- 
ing a pretty free discharge of healthy puss took place from 
the parotid swelling, which is perceptibly diminishing in 
size. The wound manifests no material change. Pulse, 
110 ; temperature 100.5° ; respiration, 18. 

D. HAYES AGNEW. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

August 30, 1881. 
8.30 A. M. 

The President slept the greater part of the night, awaking 
at intervals, and retaining the liquid nourishment adminis- 
tered. His general condition this morning is about the same 
as at the same hour yesterday. Pulse, 102 ; temperature, 
98.5° ; respiration, 18. 

D. HAYES AGNEW. D. W. BLISS, 

J. K. BARNES, 
J. J. W^OODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

Aiigust 30, 1881. 
12.30 p. M. 

At the morning dressing another small incision was made 
in the lower part of the swelling on the right side of the 
President's face, which was followed by a free discharge of 
healthy looking pus. A similar discharge took place througli 
the other openings. The swelling is perceptibly smaller and 
looks better. The wound remains in an unchanged condi- 
tion. There has been little rise of temperature since morning, 
but the pulse is more frequent. In other respects the condi- 
tion is about the same. Pulse, 116; temperature, 98.9° ; 
respiration, 18. 

D. HAYES AGNEW. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

August SO, 18SI. 
6.30 p. M. 

The President has passed comfortably througli the day. 
He has taken the usual amount of nourishment by the mouth, 
with stimulating enemata at stated periods. His rise of 
temperature this afternoon is a degree less than yesterday at 
the same time, and his pulse is less frequent than at noon 
to-day. The parotid swelling has been discharging more 
freely, and is continuing to diminish in size. Pulse, 109; 
temperature, 99.5° ; respiration, 18. 

D. HAYES AGNEW. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



'74 

Executive Mansion, 

August 31, 1881. 
8.30 A. M. 

The President has passed a tranquil night and this morn- 
ing his condition is quite as favorable as yesterday at the 
same hour. Pulse, 100 ; temperature, 98.4° ; respiration, 
18. 

FRANK H. HAMILTON, D. W. BLISS, 

D. HAYES AGNEW. J. K. BARNES, 

J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

August 31, 1881. 
12.30 p. M. 

At the dressing of the President this morning the parotid 
swelling was found to be discharging freely. It looks well, 
and has materially diminished in size. The wound remains 
in about the same state. His general condition is evidently 
more favorable than at this hour yesterday. Pulse, 95 ; 
temperature, 98.4°; respiration, 17. 

FRANK H. HAMILTON, D. W. BLISS, 

D. HAYES AGNEW. J. K. BARNES, 

J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

August 31, 1881. 
6.30 p. M. 

Tlie President has passed a better day than for some time 
past. He has taken his food with increased relish, and the 
usual afternoon rise of temperature did not occur. At the 
evening dressing the fluid used to wash out the parotid 
abscess found its way into the mouth, which it did not do 



7o 

this morning, showing that an opening into the niontli has 
spontaneously occurred. The abscess is discliarging freely, 
and the swelling continues to diminish. There is some in- 
crease in the discharge of pus from tlie wound. Pulse, 109 ; 
temperature, 98.6°; respiration, 18. 

FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD. 
ROBT. REYBURN. ' 



Executive Mansion, 
8.30 A. M. September 1, 1881. 

Towards nine o'clock last evening the President had some 
feverishness, and his pulse ranged from 108 to 116. This 
condition, which was unaccompanied by rigors or sweatino-, 
had subsided by midnight and did not interfere with his 
sleep. He had on the whole a good night, and this morn- 
ing his condition is fully as favorable as yesterday at the 
same hour. Pulse^ 100 ; temperature, 98.4°; respiration, 17. 
FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES, 
J. J, WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 
12.30 p. M. SeiDtemher 1, 1881. 

At the morning dressing of the President the abscess of 
the parotid was found to be discharging +reely. It looks 
well and continues to diminish in size. The state of the 
wound remains the same. His general condition is not 
materially different from what it was at this hour yesterday, 
except that the pulse is somewhat more frequent. Pulse, 
108 ; temperature, 98.6°; respiration, 18. 
FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



76 

Executive Mansion, 

September 1, 1881. 
6.30 p. M. 

The condition of the President has not materially changed 
since the last bulletin, except that there has been a moderate 
rise of temperature this afternoon. It having been repre- 
sented to us that a portion of this morning's bulletin has 
been misunderstood, we would state that the President has 
had no rigors for several weeks. At present his pulse is 108 ; 
temperature, 99.4°; respiration, 18. 

FPvANK H. HAMILTON. D. W. BLISS. 

J. K. BARNES, 
J. J. WOODWARD, 
ROBERT REYBURN. 



Executive Mansion, 

September 2, 1881. 
8.30 A. M. 

The President slept well during the night, and this morning 
his condition is, in all respects, as favorable as yesterday at the 
same hour. 

Pulse, 100; temperature, 98.4°; respiration, 17. 
FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES. 
J. J. WOODWARD, 
ROBERT REYBURN. 



ExEcuTR'E Mansion, 

September 2, 1881. 
12.30 p. M. 

The President's condition has not materially changed since 
the morning bulletin was issued. Pulse, 100 ; temperature, 
98.7°; respiration, 18. 

FRANK H. HAMILTON. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



77 

Executive Mansion, 

September 2, 1881. 
6.30 p. M. 

The President has passed a comfortable day, and this even- 
ing appears better than for some days past. He has taken 
a larger proportion of nutriment by the mouth and mani- 
fested greater relish for it. His pulse shows some improve- 
ment as regards frequency and strength. The parotid ab- 
scess continues to improve. The wound shows as yet little 
change. This evening his pulse is 104 ; temperature, 99.2°; 
respiration, 18. 



FRANK H. HAMILTON. 



D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

September Z, 1881. 
8.30 A. M. 

The President was somewhat more restless than usual during 
the early part of the night, but slept better after 1 a. m. This 
morning his general condition does not differ materially 
from what it was at the same hour yesterday, except that 
there is a slight increase in the frequency of the pulse. 
Pulse, 104; temperature, 98.6°; respiration, 18. 



FRANK H. HAMILTON. 



D. W. BLISS, 
J. K. BARNES, 
J. J. WOODW^ARD. 
ROBT. REYBURN. 



78 



Executive Mansion, 

Sej^temher 3, 1881. 
12.30 p. M. 

The President's condition has not materially changed since 
the morning bulletin was issued. Pulse, 104; temperature. 
98.4°; respiration, 18. 



FRANK H. HAMILTON, 
D. HAYES AGNEW. 



D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

September 'i, 1881. 
6.30 p. M. 

The President has done well during the day, and has taken, 
with some relish, a sufficient quantity of nutriment. The 
parotid swelling continues to discharge freely and to dimin- 
ish in size. The wound shows no material change. Alto- 
gether his general condition exhibits some im})rovement over 
yesterday. Pulse, 102 ; temperature, 99.6°; respiration, 18. 
D. HAYES AGNEW. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



Executive Mansion, 

September 4, 1881. 
8.30 A. M. 

The President vomited once late last evening, and once 
about an hour after midnight. Notwithstanding this dis- 
turbance he slept well most of the night, and this morning 
has taken food by tlie mouth without nausea, and has retained 
it. His pulse is somewhat more frequent, but in other 
respects his condition is about the same as at this hour yes- 
terday. 

Pulse, 108; temperature 98.4°; respiration, 18. 
D. HAYES AGNEW. D. W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



79 

Executive Mansion, 

September \, 1881. 
12.30 p. M. 

The Presidents condition has not changed material!}' since 
the last bulletin was issued, and there has been no further 
gastric disturbance. Pulse, 106 ; temperature, 98.4°; res- 
piration, 18. 

D. HAYES AGNEW. D. W. BLISS, 

J. K. BAPtNES, 
J. J. WOODWAPD, 
ROBT. REYBUPtN. 



Executive Mansion, 

September 4, 1881. 

6.30 P. M. 

The President has passed a comfortable day. He has 
taken his food with some relish and had no return of the irri- 
tability of stomach reported in the morning's bulletin. The 
parotid swelling continues to improve, and is now so far re- 
duced that the contour of his face is restored. The wound 
shows no material change. The rise of temperature this 
afternoon has been very slight, but his pulse was more fre- 
quent throughout the day than yesterday or the day before, 
and he showed more fatigue after the dressings. Pulse, 110 ; 
temperature, 99°; respiration, 18. 

D. HAYES AGNEW. T). W. BLISS, 

J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



80 



Executive Mansion, 

September 5, 1881. 



8.30 A M. 



The President was somewhat restless during the early part 
of the night, but slept well after midnight. He has taken 
by the mouth and retained the nutriment prescribed. This 
morning his pulse is less frequent than yesterday. His tem- 
perature is a degree above normal. Pulse, 102 ; temperature, 
99.5 ; respiration, 18. 



D. HAYES AGNEW. 



D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



12.30 p. M. 



Executive Mansion, 

September 5, 1881. 



The President's condition has not changed materially since 
the last bulletin was issued, except that there is some increase 
in the frequency of the pulse. He has taken, with some 
relish, the nourishment administered by the mouth, and had 
no return of gastric irritability. 

Pulse, 114 ; temperature, 99.5°; respiration, 18. 



D. HAYES AGNEW. 



D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN. 



81 



6.30 p. M. 



Executive Mansion, 

September 5, 1881. 



No material change has taken place in the condition of the 
President since morning. The parotid abcess continues to 
improve, and the wound remains about the same. The pulse 
is somewhat less frequent than at noon. At present it is 
108; temperature, 99.8°; respiration, 18. Should no un- 
toward symptoms prevent, it is hoped to move tlie President 
to Long Branch to-morrow. 

D. HAYES AGNEW. D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



Long Branch, N, J., 

September 6, 1881. 
6.30 p. M. 

Since the last bulletin was issued the President has been 
removed from Washington to Long Branch, He was more 
restless than usual last night, being evidently somewhat 
excited by anticipations of the journey. This morning at 
5.30 A. M. his pulse was 118; temperature, 99.8°; respira- 
tion, 18. We left Washington with the President at 6.30 
A. M. Owing to the admirable arragements made by the Penn- 
sylvania railroad company, and to the ingeniously-arranged 
bed, designed by Mr. T. N. Ely, the fatigue incident to the 
transportation was reduced to a minimum. Nevertheless, as 
was anticipated^ some signs of the disturbance produced by 
the journey have been exhibited since his arrival, by rise of 
temperature and increased frequency of pulse. At present 
his pulse is 124 ; temperature, 101.6°; respiration 18. 
FRANK H. HAMILTON, D. W. BLISS, 

D. HAYES AGNEW. J. K. BARNES, 

J. J. WOODWARD, 
ROBT. REYBURN. 



82 

Elberon, N. J., 
8e2)temher 7. 1881. 

9 A. M. 

The Piesident slept the gi-eater part of the night, awaken- 
ing, however, as often as it was necessary to give nourish- 
ment, which he took very well. The fever reported in last 
evening's bulletin had subsided by 11 p. m. This raoi'ning 
his temperature is normal, and he appears to have quite 
recovered from the fatigue of yesterday's journey. At the 
morning dressing the parotid abscess was found to be doing 
well. The visible part of the wound looks somewhat better. 
Pulse, 106; temperature, 98.4°; respiration, 18. 

The next bulletin will be issued at 6 o'clock this evening. 

FRANK H. HAMILTON, D. W. BLISS, 

D. HAYES AGNEW. J. K. BARNES, 

J. J. WOODWARD, 
ROBT. REYBURN. 



Elberon, N. J., 
September 7, 1881. 
6 p. M. 

Notwithstanding the exceptional heat of the the weather, 
[the thermometer in his bedroom rose to 94° at half-past 
three this afternoon,] there was a breeze most of the day, so 
that the Pi-esident was comparatively comfortable. He has 
taken his nourishment regularly, and has slept at intervals 
during the day. At 12.15 p. m. his pulse was 114; tem- 
perature, 98.4°; respiration, 18. Since then there has been 
some rise of temperature, though less than yesterday, and 
the pulse has somewhat diminished in frequency. At the 
evening dressing the appearance of the wound was favorable. 
At present his pulse is 108 ; temperature, 101°; respi- 
ration, 18. 

FRANK H. HAMILTON, D. W. BLISS, 

J. K. BARNES, 

J. J. WOODWARD, 

ROBT. REYBURN. 



83 

Elberon, N. J., 

September 8, 1881. 
8.30 A. M. 

At the morning examination made at 8 o'clock, the Presi- 
dent's pulse was 104; temperatnre, 98.7°, and respiration, 
18. He was restless and wakeful during the early part of 
the night, but after 12 (midnight) slept well until morning. 
His general condition appears more encouraging. 

D. W. BLISS, 
FRANK H. HAMILTON. 



Elberon, N. J., 
September 8, 1881. 
6 p. M. 

At 12 M. to-day the President's temperature was 98.4°; 
pulse, 94; respiration, 1*7. At the evening dressing, 5.30 
p. M., his temperature was 99.1°; pulse, 100; respiration, 
18. He has taken a liberal amount of food (both solid and 
fluid) witli apparent relish. 

By special request of the President it has been made our 
duty to say, in this public manner, to Surgeon-General J. 
K. Barnes, Surgeon J. J. Woodward, and Dr. Robert Rey- 
burn, tliat, in dispensing temporarily with their services as 
his medical attendants, he was actuated only by a wish to 
relieve them of a labor and responsibility which in his im- 
I)roved condition he could no longer properly impose upon 
them. Both the President and Mrs. Garfield desire us to 
express to these gentlemen personally, and in this same pub- 
lic manner, their high appreciation of the great skill and 
discretion which they have so constantly exercised as asso- 
ciate counsel in the management of his case up to the present 

time. 

D. W. BLISS, 

FRANK H. HAMILTON. 



84 

Elberon, N. J., 

September 9, 1881. 

8.30 A. M. 

At the examination of the President at 8 a. m., the tem- 
perature was 98.5°; pulse, 100; respiration, 17. The con- 
ditions of the parotid and wound are improving ; he was 
somewhat wakeful during the night, but not restless, and 
slept sufficiently. The enemata and stimulants have been 
suspended during the past thirty-six hours. On the whole, 
the past twenty-four hours give evidence of favorable progress. 

D. W. BLISS, 

FRANK H. HAMILTON. 



Elberon, N. J., 

September 9, 1881. 

6 p. M. 

At the examination of the President at 12 M. to-day, the 
temperature was 98.4°; pulse, 100; respiration, 17. At the 
evening dressing, at 5.30 p. m., the temperature was 98.8°; 
pulse, 100; respiration, 18. 

It is believed, without referring to the records, that this is 
the first day since the development of the traumatic fever 
tliat the temperature, pulse, and respiration have been so 
nearly normal and uniform throughout the entire day. 

D. W. BLISS, 

FRANK H. HAMILTON, 

D. HAYES AGNEW. 



85 

Elberon, N. J., 

September 10, 1881. 
9 A. M. 

At the examination of the President at 8. oO tliis a. m., the 
temperature was 99.4°; pulse, 104; respiration, 18. He 
slept well during the night, awakening only at intervals of 
one-half to one hour. There is a perceptihle increase of 
strength with an improved condition of the digestive appara- 
tus. The tumefaction of the parotid has entirely disapi)eared, 
and the suppuration greatly diminished. The wound con- 
tinues to improve, and presents a more healthy appearance. 

D. W. BLISS, 
D. HAYES AGNEW. 



Elberon, N. J., 

September 10, 1881. 
6 p. M. 

At the examination of the President at 12 m to-day his 
temperature was 98.5°; pulse, 100 ; respiration, 18. At 
5.30 this evening his temperature was 98.7°; pulse, 100 ; 
respiration, 18. The President has taken a greater amount 
of liquid, with some solid food, and with more relish than 
for several days. His general condition is quite as fevorable 
as yesterday. 

D. W. BLISS, 

D. HAYES AGNEW 

Elberon, N. J., 

September 11, 1881. 

9 A. M. 

At the examination of the President at 8.30 this a. m. his 
temperature was 98.8^; pulse, 104 ; respiration, 19. He 
was more restless, and the febrile rise later than on the pre- 
ceding night. He continues to take sufficient nourishment 

without gastric disturbance. 

D. W. BLISS, 

D. HAYES AGNEW. 



86 

Elberon, N. J., 

Septemher 11, 1881. 

6 p. M. 

The President has passed a quiet day, although the tem- 
perature has been somewhat higher and his pulse more fre- 
quent than during the previous twenty-four hours. At the 
evening dressing quite a large slough of connective tissue 
was removed from the region of the parotid, 

He continues to take a sufficient quantity of nourishment, 
and enjoys it. At the noon examination his temperature was 
100°; pulse, 110; respiration, 20. At the evening dressing 
his temperature was 100.6^; pulse, 110 ; respiration, 20. 

D. W. BLISS, 

D. HAYES ACINEW. 



Elberon, N. J., 

Septemher 12, 1881. 

9 A. M. 

The President passed an unusually good night, his sleep 
being uninterrupted, except occasionally to enable him to 
take nourishment. The suppuration from the parotid has 
almost entirely ceased ; the openings from which the pus 
discharged are rapidly healing. 

The cough is less and the expectoration materially dimin- 
ished. Temperature, 98.4°; pulse, 100 ; respiration, 18. 

D. W. BLISS, 

D. HAYES AGNEW. 



87 

Elberon, N. J., 

September 12, 1881. 
6 p. M. 

The President has experienced since the issue of the morn- 
ing bulletin further amelioration of symptoms. He has 
been able to take an ample amount of food without discom- 
fort, and has had several refreshing naps. At the noon ex- 
amination the temperature was 99,2°; pulse 106 ; respira- 
tion, 20. At 5.30 p. M. the temperature was 98,6°; pulse, 
100; respiration, 18. 

D. W. BLISS, 

D. HAYES AGNEW. 



Elberon, N. J., 

September 18, 1881. 
8.30 A. M. 

At the examination of the President at 8 a. m. to-day the 
temperature was 99.4°; pulse, 100; respiration, 20. He 
passed a comfortable night, sleeping most of the time, and, 
on the whole, his condition this morning is more encourag- 
ing and gives promise of a good day. 

D. W. BLISS, 

FRANK H. HAMILTON. 



Elberon, N. J., 

September 13, 1881. 
6 p. M. 

At the examination of the President at 12 m. to-day the 
temperature was 98.8°; pulse, 100; respiration, 20. At the 
evening dressing, 5.30 p. m., the temperature was 98.4° 
pulse, 100; respiration, 20. The President was placed in a 
semi-recumbent position upon an invalid-chair at 11 a. m., 
and remained one-half hour without fatigue or discomfort. 
The wounds are making the usual favorable progress, and 
his general condition is reassuring. 

D. W. BLISS, 

FRANK H. HAMILTON. 



88 

Elberon. N. J.. 

September 14, 1881. 
9 A. M. 

At the examination of the President at 8.30 this morning 
the temperature was 98.4°; pulse, 100; respiration, 19. 
He passed the night comfortably, sleeping sufficiently. He 
is bright and cheerful this morning, and has taken fruits and 
his first meal for the day with relish. 

D. W. BLISS, 

FRANK H. HAMILTON. 



Elberon, N. J., 

September 14, 1881. 
6.30 p. M. 

At the examination of the President at 12 m. to day his 
temperature was 98.8° ; pulse, 104; respiration, 20. At the 
evening dressing, 5.30 p. m., the temperature was 99.2° ; 
pulse, 112; respiration, 21. The President was placed on 
the invalid-chair, in a semi-reclining position^ about 12 m., 
and remained one hour and a half, sleeping a part of the 
time. He was not fatigued by the transfer or change of posi- 
tion, and his general condition this evening is as favorable as 
usual notwithstanding a slight febrile rise. 

D. W. BLISS, 

FRANK H. HAMILTON, 

D. HAYES AGNEW. 



Elberon, N. J., 

September 15, 1881. 
9 A. M. 

At the morning dressing, 8.30 to-day, the President's 
temperature was 98.4°; pulse, 100; respiration, 20. He 
passed the night comfortably, sleeping until 3 a. m., when 
he was wakeful for a period of two hours, during which time 
the pulse rose to 120, but without the marked elevation of 



89 

temperature which has characterized the febrile disturbance 
heretofore. After this time he slept quietly until nioiiiing. 
More nourishment was given during the night than for sev- 
eral nights i3ast. In reviewing the case of the President since 
his arrival at Long Branch it may be said that in spite of 
the various sceptic accidents which have for several weeks, 
and do still, complicate his case, he has certainly not retro- 
graded, but, on the contrary, has made some progress towards 
convalescence. 

D. W. BLISS, 

FRANK H. HAMILTON, 

D. HAYES AGNEW. 



Elberon, N, J., 

Se2Jtemher , 15, IS 81. 
6 p. M. 

The President has passed a quiet day, sleeping a little ; 
has coughed occasionally, the expectoration being less puru- 
lent. A greater quantity of nourishment has been taken 
without discomfort. He was placed upon the invalid-chair 
and remained forty-five minutes in a position a little more 
elevated than on previous occasions. At 12m. to-day his 
temperature was 98.9° ; pulse, 102 ; respiration, 21. At 
the evening dressing, 5.30 p. m., the temperature was 99.2° ; 
pulse, 104 ; respiration, 21. 

D. W. BLISS, 

FRANK H. HAMILTON, 

D. HAYES AGNEW. 



Elberon, N. J., 

September 16, 1881. 
9 A. M. 

At the examination of the President at 8.30 this morning 
the temperature was 98.6°; pulse, 104; respiration, 21. 

The febrile rise during the night was not so pronounced as 
it usually has been. There was, at times, considerable accel- 
eration of pulse. He, however, slept comparatively well 



90 

and took stimulants and nourishment as directed. The 
cough was somewhat more troublesome during the first part 
of the night, and the expectoration rather more purulent. 
The discharge from the wound is less abundant and not 
quite so healthy in appearance. The pulse, however, has 
more volume, and his general condition does not seem to 
have materially changed in any respect. 

D. W. BLISS, 

FRANK H. HAMILTON. 



Elberon, N. J., 
September 16, 1881. 
6 p. M. 

At the examination of the President at 12 m. to-day the 
temperature was 99.8°; pulse, 116; respiration, 21. Atthe 
evening dressing, at 5.30 p. m., the temperature was 98.6°; 
pulse, 104 ; respiration, 22. A slight febrile rise occurred at 
11 A. M., and had entirely subsided at 2 o'clock p. m. 
The condition of the wound remains unchanged ; the cough 
has not been so frequent or persistent, but the sputa still re- 
mains purulent. Nourishment and stimulants have been 
given in increased quantities without discomfort. Altogether 
his general condition cannot be said to be improved. 

D. W. BLISS, 
FRANK H. HAMILTON, 
D. HAYES AGNEW. 



Elberox^ N. J., 

September 17, 1881. 

9 A. M. 

At the morning examination and dressing of the Presi- 
dent the temperature was 99.8°; pulse, 108, and respiration, 
21. 

The fluctuations of the pulse during the night varied from 
116 to 130, the temperature during this time not deviating 
much from normal. 



91 

He slept quite well, taking aoui-ishinent at proper 
intervals. His cough was not troublesome, and the expec- 
toration moderate. The discharge from the wound is more 
healthy, and the color of the granulations slightly im- 
proved. 

D. W. BLISS, 

D. HAYES AGNEW. 



Elberon, N, J., 

September 17, 1881. 
6 p. M. 

At the examination of the President at 12 m. to-day the 
temperature was 100.2° ; pulse, 120 ; respiration, 24. 

At 11.30 he had a severe chill, lasting half an hour, fol- 
lowed by perspiration. Since the noon examination there 
has been a gradual fall of temperature, with diminished 
frequency of pulse and respiration, so that at the evening 
examination the temperature was 98° : pulse, 102 ; respira- 
tion, 18. 

He has slept most of the time during the afternoon and 
has taken his nourishment at proper intervals. The cough 
has been less frequent than usual. 

D. W. BLISS, 

D. HAYES AGNEW. 



Long Branch, N. J., 

Sepfembe?' 18, 1881. 

9 A. M. 

At the examination of the President at 8.30 this a. m. the 
temperature was 98°; pulse, 102; respiration, 18. There 
was no perceptible febrile rise during the night, the pulse 
ran sins from 102 to 112. 



92 

The cough was less troublesome than on previous nights, 
and the expectoration unchanged. He is able to take the 
nourishment and stimulants required without gastric dis- 
turbance nor has there been evidence of mental aberration 
during the night. 

D. W. BLISS, 

FRANK H. HAMILTON, 

D. HAYES AGNEW. 



Elberon, N. J., 

September 18, 1881. 
6 p. M. 

The President, though quite weak, has passed aver}' quiet 
day. There has been no recurrence of chill nor mental dis- 
turbance. At 9 A. M. a slight febrile rise took place and 
began to subside at 11 o'clock, at which time the temperature 
was 100°; pulse, llfj ; respiration, 20. There has been no 
increase of cough or change in character of the expectoration. 
At the evening examination, at 5.30 p. m., the temperature 
was 98.4°; pulse, 102 ; respiration, 20. 

D. W. BLISS, 

D. HAYES AGNEW. 



Elberon, N. J., 

September 19, 1881. 
9 A. M. 

The condition of the President this morning continues un- 
favorable. Shortly after the issue of the evening bulletin he 
had a chill, lasting fifteen minutes. The febrile rise follow- 
ing continued until 12 midnight, during which time the 
pulse ranged from 112 to 130. The sweating that followed 
was quite profuse. The cough, which was troublesome 
during the chill, gave him but little annoyance the remainder 
of the night. This morning, at 8 a. m., the temperature 
was 98.8°; pulse, 106 and feeble ; respiration, 22. At 8.30 
another chill came on, on account of which the dressing was 
temporarily postponed. A bulletin will be issued at 12.30 p. m. 

D. W. BLISS, 
D. HAYES AGNEW. 



93 

Elberon, N. J., 

September 19, 1881. 
12.30 p. M. 

The chill from which the President wa.s sufFerinjij at the 
time the morning bulletin was issued lasted about fifteen 
minutes, and was followed by febrile rise of temperature and 
sweating. 

He has slept much of the time, but his general condition 
has not materially changed since. Temperature, 98.2°; pulse, 
104 ; respiration, 20. 

D. W. BLISS, 

D. HAYES AGNEW. 



Elberox, N. J., 

September 19, 1881. 
6 p. M. 

Though the gravity of the President's condition continues, 
there has been no aggravation of symptoms since the noon 
bulletin was issued. He has slept most of the time, cough- 
ing but little, and with more ease. The sputa remains un- 
changed. A sufficient amount of noiu-ishment has been 
taken and retained. 

Temperature, 98.4°; pulse, 102 ; respiration, 18. 

D. W. BLISS, 
FRANK H. HAMILTON, 
D. HAYES AGNEW. 



Elberon, N. J,, 

September 19, 1S81 . 
11.30?. M. 

The President died at 10.35 p. m. After the bulletin was 
issued, at 5.30 this evening, the President continued in much 
the same condition as during the afternoon, the pulse varying 
from 100 to 106, with rather increased force and volume. 



94 

After taking nourishment lie fell into a quiet sleep. About 
thirty-five minutes before his death, and while asleep, his 
pulse rose to 120, and was somewhat more feeble. At 10 
o'clock he awoke, complaining of a severe pain above the 
region of his heart. He almost immediately became un- 
conscious, and ceased to breathe at 10.35. 

D. W. BLISS, 

FRANK H. HAMILTON, 

D. HAYES AGNEW. 



PULL OFFICIAL REPORT OF 
THE AUTOPSY. 



Official record of the post-mortein examination of the body of Presi- 
'dent James A. Garfield, made September 20, 1881, commenclno; at 4.30 
P.M., eighteen liours after death, at Francklyn Cottage, Elberon, X. J. 
Present and assisting Dr. D. W. Bliss, Snrgeon-General J. K. Barnes, 
Snrgeon J. J. Woodward, U. S. A., Dr. Robert Kej^burn, Dr. Frank IL 
Hamilton, Dr. D. Hayes Agnew, Dr. Andrew H. Smitli, of Elberon. 
(and New York), and Acting Assistant Surgeon D. S. Lamb, of the 
Army Medical Museum, Washington, D. C. 

Before commencing the examination a consultation was 
held by these physicians in a room adjoining that in which 
"the body lay, and it was unanimously agreed that the dis- 
section should be made by Dr. Lamb, and that Surgeon 
Woodward should record the observations made. It was 
further unanimously agreed that the cranium should not Vje 
-opened. Surgeon Woodward then proposed that the exam- 
ination should be conducted as follows : 

That the body should be viewed externally, and any mor- 
bid appearances existing recorded. That a catheter should 
then be passed into the wound, as was done during life, to 
■wash it out for the purpose ot assisting to find the position 
of the bullet. That a long incision should next be made from 
the superior extremity of the sternum to the pubis, and this 
crossed by a transverse one just below the umbilicus. That 
the abdominal flaps thus made should then be turned back 
and the abdominal viscera examined. That after the abdom- 
inal cavity was opened the position of the bullet should 
:be ascertained if possible before making any further incision, 
and that finally the thoracic viscera should be examined. 
This order of procedure was unanimously agreed to. 

The examination was then proceeded with, and the follow- 
ing external appearances were observed: The body was con- 



96 

siderably emaciated, but the face was much less wasted than 
the limbs. A preservative fluid had been injected by the 
embalmer a few hours before into the left femoral artery. 
The pipes used for tlie purpose were still in position. The 
anterior surface of the body presented no abnormal appear- 
ances, and there was no ecchymosis or other discoloration of 
any part of the front of the abdomen. Just below the right 
ear, and a little behind it, there was an oval ulcerated open- 
ing about half an inch in diameter, from which some sanious 
pus was escaping, but no tumefaction could be observed in 
the parotid region. 

A considerable number of purpura-like spots were scattered 
thickly over the left scapula, and thence forward as far as 
the axilla. They ranged from one-eighth to one-fourth of 
an inch in diameter, were slightly elevated, and furfuraceous 
on the surface, and many of them were confluent in groups 
of two to four or more. A similar but much less abundant 
eruption was observed sparsely scattered over the correspond- 
ing region on tlie right side. An oval excavated ulcer about 
an inch long, the result of a small carbuncle, was seated over 
the spinous process of the tenth dorsal vertebra. Over the 
sacrum there were four small bed sores, the largest about half 
an inch in diameter. A few acne pustules and a number of 
irregular spots of post-mortem hypostatic congestion were 
scattered over the shoulders, back, and buttocks. The in- 
ferior part of the scrotum was much discolored by hypostatic 
congestion. A group of hemorrhoidal tumors, rather larger 
than a walnut, protruded from the anus. 

The depressed cicatrix of the wound made by the pistol- 
bullet was recognized over the tenth intercostal space, three 
and a half inches to the right of the vertebral spines. A 
deep linear incision (made in part by the operation of July 
24 and extended by that of August 8) occupied a position 
closely corresponding to the upper border of the right twelfth 
rib. It commenced posteriorly, about two inches from the 
vertebral soines and extended forward a little more than 



97 

three inches. At the anterior extremity of this incision tliere 
was a deep, nearly square, ahraded surface about an iucli 
across. 

A well-oiled, flexible catheter, fourteen inches h)n'^ was 
then passed into this wound, as had been done to wash it out 
during life. More resistance was at first encountered than 
had usually been the case, but after several trials the catheter 
entered without any violence to its full length. It was then 
left in position and the body disposed supinely for the ex- 
amination of the viscera. 

The cranium was not opened. 

A long incision was made from the superior extremity of the 
sternum to the pubis, followed by a transverse incision cross- 
ing the abdomen just below the umbilicus. The four flaps 
thus formed were turned back and the abdominal viscera ex- 
posed. The subcutaneous adipose tissue, divided by the in- 
cisions, was little more than one-eighth of an inch thick over 
the thorax, but was thicker over the abdomen, being about a 
quarter of an inch along the linea alba, and as much as lialf 
an inch thick towards the outer extremity of the transverse 
incision. On inspection of the abdominal viscera t?i situ the 
transverse colon was observed to lie a little above the line of 
the umbilicus. It was firmly adherent to the anterior edse 
of the liver. The greater omentum covered the intestines 
pretty thoroughly from the transverse colon almost to the 
pubis. It was still quite fat and was very much blackened 
hy venous congestion. On both sides its lateral margins 
were adherent to the abdominal parietes opposite the eleventh 
and twelfth ribs. On the left side the adhesions were numer- 
ous, firm, well-organized, and probably old. (A foot-note 
liere says : These adhesions and the firm ones on the right 
side, as well as those of the spleen, possibly date back to an 
attack of chronic dysentery, from which the patient is said to 
have suffered during the civil war.) On the right side there 
were a few similar adhesions and a number of more delicate 
and probably recent ones. 



98 

A mass of black coagulated blood covered and concealed 
the spleen and the left margin of the greater omentum. On 
raising the omentum it was found that this blood mass ex- 
tended tlirough the left lumbar and iliac regions and dipped 
down into the pelvis, in which there was some clotted blood 
and rather more than a pint of bloody fluid. (A foot note here 
says : A large part of this fluid had probably transuded from 
the injecting material of the embalmer.) The blood coagula^ 
having been turned out and collected, measured very nearl}^ 
a pint. It was now evident that secondarj'- hemorrhage- 
had been the immediate cause of death, but the point from 
which the blood had escaped was not at once apparent. The- 
omentum was not adherent to the intestines, which were- 
moderately distended with gas. No intestinal adhesions were^ 
found other than those between the transverse colon and the- 
liver already mentioned. 

The abdominal cavity being now washed out as thoroughly 
as possible, a fruitless attempt was made to obtain some in- 
dication of the position of the bullet before making any further 
incision. By pushing the intestines aside the extremity of 
the catheter wliich had been passed into the wound could be 
felt between the peritoneum and the right iliac fascia, but 
it had evidently doubled upon itself, and although a pro- 
longed search was made, nothing could be seen or felt to in- 
dicate the presence of the bullet, either in that region or 
elsewhere. The abdominal viscera were then carefully re- 
moved from the body, placed in suitable vessels, and examined 
seriatim, with the following result : The adhesions 
between the liver and transverse colon proved to bound an 
abscess cavity between the under surface of the liver, the- 
transverse colon and the transverse meso-colon, which in- 
volved the gall bladder and extended to about the same distance 
on each side of it, measuring six inches transversely, and four 
inches from before backward. This cavity was lined by a 
thick pyogenic membrane which completely replaced the 
capsule of that part of the under surface of the liver occupied 
by the abscess. It contained about two ounces of jj-reenish- 



99 

yellow fluid, a mixture of pus and biliary matter. This abscess 
did not involve any portion of the substance of the liver ex- 
cept the surface with which it was in contact, and no cum- 
munication could be detected between it and any part of tlie 
wound. 

Some recent peritoneal adhesions existed between the 
upper surface of the right lobe of the liver and the dia- 
phragm. The liver was larger than normal, weighing 
eighty-four ounces. Its substance was firm, but of a pale 
yellowish color on its surface and throughout the interior of 
the organ from fatty degeneration. No evidence that it had 
been penetrated by the bullet could be found, nor were there 
any abscesses or infarctions in any part of its tissue. The 
spleen was connected to the diaphragm by firm, probal}ly 
old, peritoneal adhesions. There were several rather deep 
congenital fissures in its margins, giving it a lobulated ap- 
pearance. It was abnormally large' weighing eighteen 
ounces, of a very dark, lake-red color, both on the surface 
and on section. Its parenchyma was soft and flabby, but 
contained no abcesses or infarctions. There were some re- 
cent peritoneal adhesions between the posterial wall of the 
stomach and the posterior abdominal parietes. With this 
exception no abnormities were discovered in the stomach or 
intestines, nor were any other evidences of general or local 
peritonitis found besides those already specified. 

The right kidney weighed six ounces, the left kidney seven. 
Just beneath the capsule of the left kidney, at about tlie 
middle of its convex border, there was a little abscess one- 
third of an inch in diameter. There were three small serious 
cysts on the convex border of the right kidney just beneath 
its capsule. In other respects the tissue of both kidneys 
was normal in appearance and in texture. 

The uninary bladder was empty. Behind the riglit kidney, 
after the removal of that organ from the body, the dilated 
track of the bullet was dissected into. It was found that 
from the point at which it had fractured the right eleventh 
rib (three inches and a half to the right of the vertebral 



100 

spines) the missile had gone to the left, obliquely forward, 
passing through the body of the first lumbar vertebra, and 
lodging in the adipose connective tissue immediately below 
the lower border of the pancreas, about two inches and a 
half to the left of the spinal column and behind the perito- 
neum. It had become completely encysted. 

The track of the bullet, between the point at which it had 
fractured the eleventh rib and that at which it entered the 
first lumbar vertebra, was considerably dilated, and the pus 
had liurrowed downward through tlie adipose tissue behind 
the right kidney, and thence had found its way between the 
peritoneum and the right iliac fascia, making a descending 
channel, which extended almost to tlie groin. The adipose 
tissue behind the kidney, in the vicinity of the descending 
channel, was much thickened and condensed by inflamma- 
tion. In the channel, which was found almost free from 
pus, lay the flexible ca,theter introduced into the wound at 
the commencement of the autopsy ; its extremity was found 
doubled upon itself immediately beneath the pertioneum, re- 
posing upon the iliac fascia, where the channel was dilated 
into a pouch of considerable size. This long descending 
channel, now clearly seen to have been caused by the bur- 
rowing of pus from the wound, was supposed during life to 
have ])een the track of the bullet. 

The last dorsal, together with the first and second lumbar 
vertebra? and the twelfth rib, were then removed from the 
body for more thorough examination. 

When the examination was made it was found that the 
bullet had penetrated the first lumbar vertebra in the upper 
part of the right side of its body. The aperture by which 
it entered involved the intervertebral cartilage next above, 
and was situated just below and anterior to the intervertebra 
foramen, from which its upper margin was about one-quarter 
of an inch distant. Passing obliquely to the left and forward 
through the upper part of the body of the first lumbar 
vertebra, the bullet emerged by an aperture, the center of 
which was about half an inch to the left of the median line. 



101 

and which also involved tlie inlervertehral eartilaiije next 
above. The cancellated tissnc of the body of the first Innihar 
vertebra was very much comminuted, and the fragments 
somewhat displaced. Several deep fissures extended from 
the track of the bullet to the lower part of the body of the 
twelfth dorsal vertebra, others extended thronf];h the first 
lumbar vertebra into the intervertebral cartilage between it 
and the second lumbar vertebra. Both this cartilaf]j(^ and 
that next above were partly destroyed by ulceration. A 
number of minute fragments from .the fractured lumbar 
vertebra had been driven into the adjacent soft parts. 

It was further found that the right twelfth rib also was 
fractiired at a point one inch and a quarter to the right of 
the transverse process of the twelfth dorsal vetrebra. This 
injury had not been recognized during life. 

On sawing through the vertebra, a little to the right of 
the median line, it was found that the spinal canal was not 
involved by the track of the ball. The spinal cord and 
other contents of this portion of the spinal canal presented 
no abnormal appearances. The rest of the spinal cord was 
not examined. 

Beyond the first lumbar vertebra the bullet continued to 
go to the left, passing behind the pancreas to the point 
where it was found. Here it was enveloped in a firm cyst of 
connective tissue, which contained, besides the ball, a minute 
quantity of inspissated somewhat cheesy pus, which formed 
a thin layer over a portion of the surface of the lead. There 
was also a black shred adherent to a part of the cyst wall, 
which proved, on microscopical examination, to be the 
remains of a blood clot. For about an inch from this cySt, 
the track of the ball behind the pancreas was completely 
obliterated by the healing process, thence as far backward 
as the body of the first lumbar vertebra the track was filled 
with coagulated blood, which extended on the left into an irreg- 
ular space rent in the adjoining adipose tissue behind the peri- 
toneum and above the pancreas. The blood had worked its 
way to the left, bursting finally through the peritoneuhi 



102 

behind the spleen into the ahdominal cavity. The rending of 
the tissue by the extravasation of this blood was undoubtedly 
the cause of the paroxysms of pain which occurred a short 
time before death. This ma ss of coagulated blood was of 
irregular form, and nearly as large as a man's fist. It could 
be distinctly seen from in front, through the peritoneum, 
after its site behind the greater curvature of the stomach had 
been exposed by the dissection of the greater omentum from 
the stomacli, and especially after some delicate adhesions 
between the stomach and the part of the peritoneum covering 
the blood mass had been broken down by the fingers. From 
the relations of the mass as thus seen it was believed that the 
hemorrhage had proceeded from one of the mesenteric arte- 
ries, but as it was clear that a minute dissection would be 
required to determine the particular branch involved, it was 
agreed that the infiltrated tissues and the adjoining soft 
parts should be preserved for subsequent study. 

On the examination and dissection, made in accordance with 
this agreement, it was found that the fatal hemorrhage pro- 
ceeded from a rent nearly four- tenths of an inch long in' the 
main trunk of the splenicartery, two inchesand a half totheleft 
of thecoeliac axis. This rent must have occurred at leastseveral 
days before death, since the everted edges in the slit in the ves- 
sel were united by firm adhesions to the surrounding connective 
tissue, thus forming an almost continuous wall bounding tlie 
adjoining portion of the blood-clot. Moreover, the peripheral 
portion of the clot in this vicinity was disposed in pretty firm 
concentric layers. It w^as further found that the cyst below the 
lower margin of the pancreas, in which the bullet was found, 
was situated three inches and a half to the left of the coeliac 
axis. Besides the mass of coagulated blood just described, 
another about the size of a walnut was found in the gi-eater 
omentum, near the splenic extremity of the stomach. The 
communication, if any, between this and the larger hem- 
orrhagic mass could not be made out. 

The examination of the thoracic viscera resulted as follows : 
The heart weii>;hed eleven ounces. All the cavities were 



108 

entirely empty except the rii;-lit ventricle, in wliicli ;i tew 
shreds of soft, reddi.sli c;)il^•lll;lted Itlond iidiiered to the in- 
ternal suvtacc. On the surface of the mitral valve there were 
several spots of fatty degeneration ; with this exception the 
cardiac valves were normal. The muscular tissue of the 
heart was soft and tore easily. A few spots of fatty degen- 
eration existed in the lining membrane of the aorta, just 
above the semilunar valves, and a sleniler clot of fibrin was 
found in the aorta, where it was divided about two inches 
from tliese valves for the removal of the heart. 

On the right side slight pleuritic adhesions existed l)etween 
the convex surface of the lower lobe of the lung and tlie 
costal pleura, and firm adhesions between the anterior edge 
of the lower lobe, the pericardium, and the diaphragm. The 
right lung weighed thirty-two ounces. The posterior part 
of tlie fissure, between its upper and lower lobes, was con- 
genitally incomplete. The lower lobe of the right lung was 
hypostatically congested, and considerable portions, especially 
toward its base, were the seat of broncho pneumonia. The 
bronchial tubes contained a considerable quantity of stringy 
muco pus, their raucous surface was reddened by catarrhal 
bronchitis. The lung tissue was oedematous ; (a foot-note 
here says : a part at least of this condition was doubtless due 
to the extravasation of the injecting fluid used by the em- 
balmer,) but contained no abcesses or infarctions. 

On the left side the lower lobe of the lung' was bound 
behind to the costal pleura, above to the upper lobe, and be- 
low to the diaphragm by pretty firm pleuritic adhesions. 
The left lung weighed twenty-seven ounces. The condition of 
its bronchial tubes and of the lung tissue was very nearly the 
same as on the right side, the chief difference being that tlie 
area of broncho pneumonia in tlie lower lobe was much less 
extensive in the left lung than in the right. In the lateral 
part of the lower lobe of the left lung, and about an inch 
from its plural surface there was a group of four minute 
areas of gray hepatization, each about one eighth of an inch 



104 

in diamater. Tliere were no infarctions and no abscesses in 
any part ol' the lung tissue. 

The surgeons assisting at tlie autopsy were unanimously 
of the opiniini that on reviewing the history of the case in 
connection with the autopsy, it is quite evident that the 
different suppurating suilaces and especially the fractured 
spongy tissue of the vertebra, furnish a sufficient explanation 
of the sceptic conditions which existed during life. About 
an hour after the post-mortem examination was completed 
the physicians named at the commencement of this report 
assembled for further consultation in an adjoining cottage. 
A brief outline of the results of the post-mortem examina- 
tion was drawn up, signed by all the physicians, and handed 
to Private Secretary J. Stanley Brown, who was requested to 
furnish copies to the newspaper press. 

D. W. BLISS, 
J. K. BARNES, 
J. J. WOODWARD, 
ROBT. REYBURN, 
D. S. LAMB. 

As tlie above report contains [)aragraphs detailing the 
observatit)ns made at Washington on the [)athological s[)eci- 
mens })reserved for tliat purpose, the names of Drs. F. li. 
Hamilton, D. Hayes Agnow, and A. H. Smith are not 
appernled to it. it has, however, been submitted to them, 
and they have given their assent to the other portions of the 
report. 



OFFICIAL BULLETIN OI' THE 
AUTOPSY. 



Long Branch, N. -I., 

Septonhcr 20, 1881, 

By pi'cvious iin-;uigeiiioiit a [xtst-mortoiu cxaiuiiiatiuii of 
the body of President Gartield was made tliis al'teriioon, in 
the presence and with the assistance of Drs. Hamilton, 
Agnew, Bliss, Barnes, Woodward, Reyhiirn, Andiew II. 
Smith, of Elberon, and Acting- Assistant *Surgeon 1). >S. 
Lamlj, of the Army Medical Musenm, of Washington. The 
operation was performed by Dr. Lamb. It was f>nnd tliat 
the ball, after fracturing the right eleventh rib, had passed 
through the spinal column in front of tlie spinal cord, trac- 
tui'ing the body of the first lumbar vei'tebra, driving a number 
of small fragments of bone into tlie adjacent soft parts, and 
lodging below the pancreas, about two inches and a half to 
the left of the spine, and behind the peritoneum, where it 
had become completely encysted. 

The immediate cause of death was secondary hemorrhage 
from one of the mesenteric arteries adjoining the track of the 
ball, the blood rupturing the peritoneum, and nearly a pint 
escaping into the abdominal cavity. This hemorrhage is 
believed to have been the cause of the severe pain in the lower 
part of the chest complained of just before deatli. An 
abscess-cavity, six inches by four in dimensions, was found 
in the vicinity of the gall-bladder, between the liver and the 
transverse colon, which were strongly adherent. It did not 
involve the substance of the liver, and no communication was 
found between it and the wound. 

A long, suppurating channel extended from the external 
wound, between the loin muscles and the right kidney. 



106 

almost to tlie right groin. This cliauiiel, now known to be 
due to tlie buri'owing of pus from tlie wound, was supi)t)sed, 
during, life, to have been the track of the ball. 

On an examination of the organs of the chest evidences of 
severe bronchitis were ibund on both sides, with broncho- 
pneumonia of the lower portions of the right lung, and, 
though to a much less extent, of the left. The lungs con- 
tained no abscesses, and the heart no clots. The liver was 
enlarged and fatty, but not from abscesses. Nor were any 
found in any other organ, except the left kidney, wliicli con- 
tained, near its surface, a small abscess about one-tliird of an 
incli in diameter. 

In reviewing the history of tlie case in connection with the 
autopsy, it is (juite evident that the different suppurating 
surfaces, and es[)ecially the fractured s])ongy tissue of the 
vertebrje, furnish a suiiicient explanation of the se})tic con- 
dition which existed. 

D. W. BLISS, FRANK H. HAMILTON. 

J. K. BAIiNES, D. HAYES AONEW. 

J. J. WOODWARD, ANDREW H. SMITH. 

ROBERT RE Y BURN. D. S. LAMB. 



DIAGRAM SHOWING THE COURSE TAKEN BY THE BALL. 




EXPLANATION: 

A.— Eleventh right rib, which was stnu-k by tlic liall wlion it Piitororl Dip budv 

B.— Tlie spinal column, through whicii iim ]>.t,11 jl-issciI. 

C. — The spinal Canal. 

D. — The flrst Lumbar Vertebra. 

E.— Where the ball lodged. 



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